To assess the 30-day post–cardiac arrest survival outlook for individuals receiving home care services and for nursing home residents. We performed a retrospective, population-based cohort analysis involving community-dwelling adults (≥18 years) who were treated for cardiac arrest in Ontario, Canada, from 2006 to 2018. Population-level health databases were linked, using the Home Care Dataset to determine home care recipients and the Continuing Care Reporting System to identify nursing home residents. Both out-of-hospital and in-hospital arrests were included. Logistic regression was used to estimate crude and adjusted associations, with adjustments for age and sex. Relative effects were translated into absolute risk estimates. The cohort consisted of 86,836 participants. Most arrests (55.5%) occurred outside the hospital, with 9,316 individuals receiving home care and 2,394 living in a nursing home. Compared with people without support services, 30-day survival probabilities were lower among home care recipients (RD = −6.5; 95% CI = −7.5 to −5.0), with comparable findings in both out-of-hospital (RD = −6.7; 95% CI = −7.6 to −5.7) and in-hospital arrests (RD = −8.7; 95% CI = −10.6 to −7.3). Nursing home residents also showed reduced 30-day survival (RD = −7.2; 95% CI = −9.3 to −5.3), with similar patterns in out-of-hospital (RD = −8.6; 95% CI = −10.6 to −5.7) and in-hospital arrests (RD = −5.0; 95% CI = −7.8 to −2.1). Both home care recipients and nursing home residents demonstrated poorer short-term survival after cardiac arrest than individuals without pre-arrest support, underscoring two high-needs groups that may particularly benefit from advance care planning.
