Out-of-hospital cardiac arrest secondary to electrocution: Characteristics and outcomes

Abstract

Aim

To characterise the epidemiology of Out-of-Hospital Cardiac Arrests (OHCA) secondary to electrocution and determine its association with the initial arrest rhythm and patient outcomes.

Method

Between 2000 and 2023, we retrospectively compared OHCA secondary to electrocution with medical and other non-medical aetiologies. Multivariable logistic regression was used to assess the risk-adjusted odds of presenting in a shockable rhythm and patient outcomes.

Results

Of the 118,677 OHCA cases included in the study, 113 (0.1%) were secondary to electrocution. The crude incidence was 0.11 per 100,000 person-years, reducing significantly over time (p <0.001). Electrocution cases were more likely to be male, occur in a workplace, and present in a shockable rhythm compared to medical and non-medical causes. After adjustment for arrest characteristics, the odds of presenting in a shockable rhythm were similar between electrocution and medical causes (AOR 1.08, 95% CI: 0.59, 2.01; p = 0.790) but lower for non-medical causes (AOR 0.07, 95% CI: 0.04, 0.14; p <0.001). Electrocution had higher unadjusted odds of survival to hospital discharge when compared to medical causes (OR 0.21, 95% CI: 0.21, 0.80; p = 0.009) and non-medical causes (OR 0.20, 95% CI: 0.10, 0.39; p <0.001), but this was not significant after adjustment for differences in arrest characteristics.

Conclusion

Electrocution cases had a similar likelihood of presenting in a shockable rhythm to medical causes. Electrocution was not an independent predictor of survival, with favourable prognosis appearing to be attenuated by other factors, including younger age and a higher proportion of initial shockable rhythms.