Out-of-Hospital Cardiac Arrest in individuals with Human Immunodeficiency Virus infection: A nationwide population-based cohort study
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Out-of-Hospital Cardiac Arrest in individuals with Human Immunodeficiency Virus infection : A nationwide population-based cohort study. / Garcia, Rodrigue; Warming, Peder Emil; Hansen, Carl Johann; Rajan, Deepthi; Torp-Pedersen, Christian; Benfield, Thomas; Folke, Fredrik; Tfelt-Hansen, Jacob.
In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol. 77, No. 11, 2023, p. 1578–1584.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Out-of-Hospital Cardiac Arrest in individuals with Human Immunodeficiency Virus infection
T2 - A nationwide population-based cohort study
AU - Garcia, Rodrigue
AU - Warming, Peder Emil
AU - Hansen, Carl Johann
AU - Rajan, Deepthi
AU - Torp-Pedersen, Christian
AU - Benfield, Thomas
AU - Folke, Fredrik
AU - Tfelt-Hansen, Jacob
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2023
Y1 - 2023
N2 - BACKGROUND: Little data exist on the risk and outcomes of out-of-hospital cardiac arrest (OHCA) in people with HIV (PWH). We aimed to describe OHCA in PWH as compared to the general population in terms of incidence, characteristics, and survival.METHODS: This nationwide study assessed all individuals aged 18-85 years between 2001 and 2019 in Denmark. Cumulative incidence of OHCA was computed using cause-specific Cox models accounting for competing risk of death.RESULTS: Among 6 565 309 individuals, 6 925 (median age 36 [IQR 28-44], 74% males) were infected at some point with HIV. Incidence of OHCA was 149 (95% CI 123-180)/100 000 person-years in PWH versus 64 (95% CI 64-65)/100 000 person-years in non-HIV patients (P<0.001). Age at the time of cardiac arrest was 52 (IQR 44-61) years in PWH (vs. 69 [IQR 59-77] years in individuals without HIV; P<0.001). In a multivariable model adjusted for age, sex, hypertension, diabetes, heart failure, ischemic heart disease, atrial fibrillation, chronic obstructive pulmonary disease, cancer and renal failure, PWH had a two-fold higher risk of OHCA (HR 2.84, 95% CI 2.36-3.43; P<0.001). Thirty-day mortality (89% vs 88%; P=0.80) was comparable to individuals without HIV.CONCLUSIONS: HIV is an independent risk factor of OHCA and OHCA victims with HIV are much younger than those without HIV. Almost 90% of PWH died one month after OHCA. Further research should strive to find out how to reduce OHCA occurrence in this population.
AB - BACKGROUND: Little data exist on the risk and outcomes of out-of-hospital cardiac arrest (OHCA) in people with HIV (PWH). We aimed to describe OHCA in PWH as compared to the general population in terms of incidence, characteristics, and survival.METHODS: This nationwide study assessed all individuals aged 18-85 years between 2001 and 2019 in Denmark. Cumulative incidence of OHCA was computed using cause-specific Cox models accounting for competing risk of death.RESULTS: Among 6 565 309 individuals, 6 925 (median age 36 [IQR 28-44], 74% males) were infected at some point with HIV. Incidence of OHCA was 149 (95% CI 123-180)/100 000 person-years in PWH versus 64 (95% CI 64-65)/100 000 person-years in non-HIV patients (P<0.001). Age at the time of cardiac arrest was 52 (IQR 44-61) years in PWH (vs. 69 [IQR 59-77] years in individuals without HIV; P<0.001). In a multivariable model adjusted for age, sex, hypertension, diabetes, heart failure, ischemic heart disease, atrial fibrillation, chronic obstructive pulmonary disease, cancer and renal failure, PWH had a two-fold higher risk of OHCA (HR 2.84, 95% CI 2.36-3.43; P<0.001). Thirty-day mortality (89% vs 88%; P=0.80) was comparable to individuals without HIV.CONCLUSIONS: HIV is an independent risk factor of OHCA and OHCA victims with HIV are much younger than those without HIV. Almost 90% of PWH died one month after OHCA. Further research should strive to find out how to reduce OHCA occurrence in this population.
U2 - 10.1093/cid/ciad422
DO - 10.1093/cid/ciad422
M3 - Journal article
C2 - 37448334
VL - 77
SP - 1578
EP - 1584
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 11
ER -
ID: 364347943