Abstract 4139585: Differences in Health Care Utilization Prior to Cardiac Arrest Among Patients with Shockable versus Non-Shockable Rhythms
Bibliographic record
Abstract
Background: Health care utilization has been shown to be high prior to out-of-hospital cardiac arrest (OHCA). However, differences in patterns of health care utilization between OHCA presenting with shockable and non-shockable rhythms have not been explored. Hypothesis: Health care interactions prior to cardiac arrest are more common among those presenting with non-shockable rhythms, a large proportion of which may be a manifestation of chronic disease progression. Aim: To examine health care utilization prior to OHCA and the differences between patients presenting with shockable and non-shockable rhythms, in comparison to population controls. Methods: This was a matched case-control study. Cardiac arrests from 2009-2019 were identified in the British Columbia Cardiac Arrest Registry. Age, sex and geographic population controls were identified. We examined health care utilization in the 3 years prior to cardiac arrest. Results: A total of 3,461 shockable and 11,470 non-shockable OHCA patients were identified and matched 4:1 to 45,871 controls. The rate of hospitalization in the 3 years prior was 57% in the shockable group (39.5% in controls, OR 1.66, 95% CI 1.53-1.79) and 61.5% in the non-shockable group (39.5% in controls, OR 2.67, 95% CI 2.55-2.79). Overall hospitalizations were more common in both OHCA compared to controls, while non-cardiovascular (CV) admissions were greater for the non-shockable versus shockable groups ( Figure ). When examining bi-weekly rates of hospital and ER visits leading up to OHCA, both groups had increased CV encounters arising at 10 weeks prior to arrest, whereas the non-shockable group had greater non-CV encounters as compared to the shockable group. Conclusion: Shockable and non-shockable OHCA show high rates of health care utilization leading up to cardiac arrest, which may provide opportunities for intervention. Differences between the shockable and non-shockable groups may reflect underlying pathophysiology, which has implications for prevention of OHCA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".