Characteristics and outcomes after out-of-hospital cardiac arrests in individuals with pre-existing psychiatric conditions, compared to those without

AI Summary

Pre-existing psychiatric conditions were associated with lower 30-day survival after OHCA (9% versus 12%; adjusted OR 0.52, 95% CI 0.48-0.56).
Arrests with psychiatric diagnoses were less often witnessed, less likely shockable, and more commonly caused by intoxication or suicide, particularly in younger adults.
Bystander CPR rates and neurological outcomes among survivors were similar, highlighting need for targeted prevention and early recognition strategies.

Resusc Plus. 2026 May 6;29:101356. doi: 10.1016/j.resplu.2026.101356. eCollection 2026 May.

ABSTRACT

BACKGROUND/PURPOSE: Individuals with psychiatric conditions have increased cardiovascular morbidity and mortality, yet outcomes following out-of-hospital cardiac arrest (OHCA) in this population remain insufficiently characterized. We aimed to investigate the association between pre-existing psychiatric conditions and outcomes after OHCA in a nationwide Swedish cohort.

MATERIALS AND METHODS: We conducted a registry-based cohort study including all individuals ≥16 years with OHCA reported to the Swedish Registry for Cardiopulmonary Resuscitation (2010-2020). Psychiatric conditions were identified using ICD-10 codes and categorized into major diagnostic groups. The primary outcome was 30-day survival. Secondary outcomes included neurological status at discharge (CPC score) and long-term survival. Logistic regression models adjusted for age and sex were used, and analyses were stratified by initial rhythm.

RESULTS: Among 53,981 individuals, 13,777 (26%) had a prior psychiatric diagnosis. Cardiac arrests in individuals with psychiatric conditions were less often witnessed and less likely to present with a shockable rhythm, despite similar rates of bystander CPR. Intoxication and suicide were markedly more common presumed causes, particularly among younger adults, in whom over half had a psychiatric diagnosis. Thirty-day survival was lower in individuals with psychiatric conditions (9% vs. 12%; adjusted OR 0.52, 95% CI 0.48-0.56). In stratified analyses, this association was evident in shockable but not non-shockable rhythms. Neurological outcomes among survivors were largely comparable.

CONCLUSION: Pre-existing psychiatric conditions are associated with lower survival after OHCA, largely driven by differences in arrest characteristics and etiology rather than bystander response. These findings highlight a vulnerable population and underscore the importance of targeted prevention and early recognition strategies. Keywords: Out-of-Hospital Cardiac Arrest (OHCA), Psychiatric diagnosis, Young Adults, 30-day survival, Swedish Cardiopulmonary Registry (SRCR), Emergency Medicine.

PMID:42211400 | PMC:PMC13214532 | DOI:10.1016/j.resplu.2026.101356

Document this CPD