Sudden cardiac arrest in end-stage renal disease patients on dialysis

A nationwide study

Fahad Alqahtani, Ahmed Almustafa, Kuldeep Shah, Yasir Akram, Danish Abbasi, Rohit Rattan, Navin Subrayappa, Mohamad Alkhouli, Muhammad Bilal Munir

Research output: Contribution to journalArticle

Abstract

Background: Sudden cardiac arrest (SCA) is frequently encountered in end-stage renal disease (ESRD) patients on dialysis. There is a dearth of national data on SCA-associated outcomes in this specific patient population. The aim of the present study is to study these parameters from a nationally representative US population. Methods: Data were extracted from National Inpatient Sample database from October 2005 to December 2014. All patients with clinical encounter of dialysis during the study period were enrolled. Patients who underwent SCA, ventricular fibrillation, ventricular tachycardia, and ventricular flutter were then identified by applying relevant International Classification of Diseases, Ninth Revision, Clinical Modification codes. Patients with acute kidney injury and prior renal transplant were excluded. Propensity matching was done to balance covariates among study groups. Logistic regression analysis was done to assess for predictors of SCA-associated mortality in ESRD patients on dialysis. Results: A total of 1 147 760 patients were included in the final analyses. Patients who suffered SCA were older when compared to the non-SCA cohort and had a higher burden of comorbidities. About half (52.10%) of ESRD patients who suffered SCA died. Advanced age, metabolic acidosis, and cardiogenic shock were independently associated with reduced survival after SCA. New implantable cardioverter defibrillator implantation continues to be low in this patient population at discharge. Conclusion: SCA in settings of ESRD on dialysis carries high mortality and frequent morbidity. Further research in therapeutic interventions that could prevent SCA in this vulnerable population is utmost needed.

Original languageEnglish (US)
Pages (from-to)1467-1475
Number of pages9
JournalPACE - Pacing and Clinical Electrophysiology
Volume41
Issue number11
DOIs
StatePublished - Nov 1 2018
Externally publishedYes

Fingerprint

Sudden Cardiac Death
Chronic Kidney Failure
Dialysis
Ventricular Flutter
Population
Therapeutic Human Experimentation
Cardiogenic Shock
Mortality
Implantable Defibrillators
International Classification of Diseases
Ventricular Fibrillation
Vulnerable Populations
Ventricular Tachycardia
Acidosis
Heart Arrest
Acute Kidney Injury
Comorbidity
Inpatients
Logistic Models
Regression Analysis

Keywords

  • dialysis
  • end-stage renal disease
  • sudden cardiac arrest

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Sudden cardiac arrest in end-stage renal disease patients on dialysis : A nationwide study. / Alqahtani, Fahad; Almustafa, Ahmed; Shah, Kuldeep; Akram, Yasir; Abbasi, Danish; Rattan, Rohit; Subrayappa, Navin; Alkhouli, Mohamad; Munir, Muhammad Bilal.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 41, No. 11, 01.11.2018, p. 1467-1475.

Research output: Contribution to journalArticle

Alqahtani, F, Almustafa, A, Shah, K, Akram, Y, Abbasi, D, Rattan, R, Subrayappa, N, Alkhouli, M & Munir, MB 2018, 'Sudden cardiac arrest in end-stage renal disease patients on dialysis: A nationwide study', PACE - Pacing and Clinical Electrophysiology, vol. 41, no. 11, pp. 1467-1475. https://doi.org/10.1111/pace.13498
Alqahtani, Fahad ; Almustafa, Ahmed ; Shah, Kuldeep ; Akram, Yasir ; Abbasi, Danish ; Rattan, Rohit ; Subrayappa, Navin ; Alkhouli, Mohamad ; Munir, Muhammad Bilal. / Sudden cardiac arrest in end-stage renal disease patients on dialysis : A nationwide study. In: PACE - Pacing and Clinical Electrophysiology. 2018 ; Vol. 41, No. 11. pp. 1467-1475.
@article{06d3cc16472a47f2beb6d3f9e1491995,
title = "Sudden cardiac arrest in end-stage renal disease patients on dialysis: A nationwide study",
abstract = "Background: Sudden cardiac arrest (SCA) is frequently encountered in end-stage renal disease (ESRD) patients on dialysis. There is a dearth of national data on SCA-associated outcomes in this specific patient population. The aim of the present study is to study these parameters from a nationally representative US population. Methods: Data were extracted from National Inpatient Sample database from October 2005 to December 2014. All patients with clinical encounter of dialysis during the study period were enrolled. Patients who underwent SCA, ventricular fibrillation, ventricular tachycardia, and ventricular flutter were then identified by applying relevant International Classification of Diseases, Ninth Revision, Clinical Modification codes. Patients with acute kidney injury and prior renal transplant were excluded. Propensity matching was done to balance covariates among study groups. Logistic regression analysis was done to assess for predictors of SCA-associated mortality in ESRD patients on dialysis. Results: A total of 1 147 760 patients were included in the final analyses. Patients who suffered SCA were older when compared to the non-SCA cohort and had a higher burden of comorbidities. About half (52.10{\%}) of ESRD patients who suffered SCA died. Advanced age, metabolic acidosis, and cardiogenic shock were independently associated with reduced survival after SCA. New implantable cardioverter defibrillator implantation continues to be low in this patient population at discharge. Conclusion: SCA in settings of ESRD on dialysis carries high mortality and frequent morbidity. Further research in therapeutic interventions that could prevent SCA in this vulnerable population is utmost needed.",
keywords = "dialysis, end-stage renal disease, sudden cardiac arrest",
author = "Fahad Alqahtani and Ahmed Almustafa and Kuldeep Shah and Yasir Akram and Danish Abbasi and Rohit Rattan and Navin Subrayappa and Mohamad Alkhouli and Munir, {Muhammad Bilal}",
year = "2018",
month = "11",
day = "1",
doi = "10.1111/pace.13498",
language = "English (US)",
volume = "41",
pages = "1467--1475",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "11",

}

TY - JOUR

T1 - Sudden cardiac arrest in end-stage renal disease patients on dialysis

T2 - A nationwide study

AU - Alqahtani, Fahad

AU - Almustafa, Ahmed

AU - Shah, Kuldeep

AU - Akram, Yasir

AU - Abbasi, Danish

AU - Rattan, Rohit

AU - Subrayappa, Navin

AU - Alkhouli, Mohamad

AU - Munir, Muhammad Bilal

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: Sudden cardiac arrest (SCA) is frequently encountered in end-stage renal disease (ESRD) patients on dialysis. There is a dearth of national data on SCA-associated outcomes in this specific patient population. The aim of the present study is to study these parameters from a nationally representative US population. Methods: Data were extracted from National Inpatient Sample database from October 2005 to December 2014. All patients with clinical encounter of dialysis during the study period were enrolled. Patients who underwent SCA, ventricular fibrillation, ventricular tachycardia, and ventricular flutter were then identified by applying relevant International Classification of Diseases, Ninth Revision, Clinical Modification codes. Patients with acute kidney injury and prior renal transplant were excluded. Propensity matching was done to balance covariates among study groups. Logistic regression analysis was done to assess for predictors of SCA-associated mortality in ESRD patients on dialysis. Results: A total of 1 147 760 patients were included in the final analyses. Patients who suffered SCA were older when compared to the non-SCA cohort and had a higher burden of comorbidities. About half (52.10%) of ESRD patients who suffered SCA died. Advanced age, metabolic acidosis, and cardiogenic shock were independently associated with reduced survival after SCA. New implantable cardioverter defibrillator implantation continues to be low in this patient population at discharge. Conclusion: SCA in settings of ESRD on dialysis carries high mortality and frequent morbidity. Further research in therapeutic interventions that could prevent SCA in this vulnerable population is utmost needed.

AB - Background: Sudden cardiac arrest (SCA) is frequently encountered in end-stage renal disease (ESRD) patients on dialysis. There is a dearth of national data on SCA-associated outcomes in this specific patient population. The aim of the present study is to study these parameters from a nationally representative US population. Methods: Data were extracted from National Inpatient Sample database from October 2005 to December 2014. All patients with clinical encounter of dialysis during the study period were enrolled. Patients who underwent SCA, ventricular fibrillation, ventricular tachycardia, and ventricular flutter were then identified by applying relevant International Classification of Diseases, Ninth Revision, Clinical Modification codes. Patients with acute kidney injury and prior renal transplant were excluded. Propensity matching was done to balance covariates among study groups. Logistic regression analysis was done to assess for predictors of SCA-associated mortality in ESRD patients on dialysis. Results: A total of 1 147 760 patients were included in the final analyses. Patients who suffered SCA were older when compared to the non-SCA cohort and had a higher burden of comorbidities. About half (52.10%) of ESRD patients who suffered SCA died. Advanced age, metabolic acidosis, and cardiogenic shock were independently associated with reduced survival after SCA. New implantable cardioverter defibrillator implantation continues to be low in this patient population at discharge. Conclusion: SCA in settings of ESRD on dialysis carries high mortality and frequent morbidity. Further research in therapeutic interventions that could prevent SCA in this vulnerable population is utmost needed.

KW - dialysis

KW - end-stage renal disease

KW - sudden cardiac arrest

UR - http://www.scopus.com/inward/record.url?scp=85054383683&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054383683&partnerID=8YFLogxK

U2 - 10.1111/pace.13498

DO - 10.1111/pace.13498

M3 - Article

VL - 41

SP - 1467

EP - 1475

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 11

ER -