Estimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8% to 10.0% of medical OHCA. However, studies conducted prior to the recent wave of fentanyl deaths likely underestimate the current prevalence of drug-related OHCA. We evaluated recent trends in drug-related OHCA, hypothesizing that the proportion of presumed drug-related OHCA treated by emergency medical services (EMS) has increased since 2015. We conducted a retrospective analysis of OHCA patients treated by EMS providers in San Francisco, California between 2015 and 2023. Participants included OHCA cases in which resuscitation was attempted by EMS. The study exposure was the year of arrest. Our primary outcome was the occurrence of drug-related OHCA, defined as the EMS impression of OHCA caused by a presumed or known overdose of medication(s) or drug(s). From 2015 to 2023, 5044 OHCA resuscitations attended by EMS (average 561 per year) met inclusion criteria. The median age was 65 (IQR 50–79); 3508 (69.6%) were male. The EMS impression of arrest etiology was drug-related in 446/5044 (8.8%) of OHCA. The prevalence of presumed drug-related OHCA increased significantly each year from 1% in 2015 to 17.6% in 2023 (p-value for trend = 0.0001). After adjustment, presumed drug-related OHCA increased by 30% each year from 2015-2023. Drug-related OHCA is an increasingly common etiology of OHCA. In 2023, one in six OHCA was presumed to be drug related. Among participants less than 60 years old, one in three OHCA was presumed to be drug related.

中文翻译：

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2015-2023 年旧金山推测药物过量院外心脏骤停的趋势

对与药物相关的院外心脏骤停 (OHCA) 发生率的估计各不相同，范围为医疗 OHCA 的 1.8% 至 10.0%。然而，在最近的芬太尼死亡浪潮之前进行的研究可能低估了当前与药物相关的 OHCA 的患病率。我们评估了药物相关 OHCA 的最新趋势，假设自 2015 年以来接受紧急医疗服务 (EMS) 治疗的推测与药物相关的 OHCA 比例有所增加。我们对加利福尼亚州旧金山市由 EMS 提供者治疗的 OHCA 患者进行了回顾性分析2015 年至 2023 年间。参与者包括由 EMS 尝试复苏的 OHCA 病例。研究暴露的年份是被捕的年份。我们的主要结局是药物相关 OHCA 的发生，定义为由推定或已知的药物或药物过量引起的 OHCA 的 EMS 印象。从 2015 年到 2023 年，EMS 参与的 5044 例 OHCA 复苏（平均每年 561 例）符合纳入标准。中位年龄为 65 岁（IQR 50-79）；3508 名（69.6%）为男性。EMS 对逮捕病因的印象在 446/5044 (8.8%) OHCA 中与药物相关。推测与药物相关的 OHCA 患病率每年显着增加，从 2015 年的 1% 增加到 2023 年的 17.6%（趋势 p 值 = 0.0001）。调整后，2015 年至 2023 年期间，推测与药物相关的 OHCA 每年增加 30%。药物相关 OHCA 是 OHCA 越来越常见的病因。到 2023 年，六分之一的 OHCA 被认为与毒品有关。在 60 岁以下的参与者中，三分之一的 OHCA 被认为与毒品有关。