High survival rate of 43% in out-of-hospital cardiac arrest patients in an optimised chain of survival

Abstract

AimsSurvival to hospital discharge after out-of-hospital cardiac arrest (OHCA) varies widely. This study describes short-term survival after OHCA in a region with an extensive care path and a follow-up of 1 year.MethodsConsecutive patients ≥16 years admitted to the emergency department between April 2011 and December 2012 were included. In July 2014 a follow-up took place. Socio-demographic data, characteristics of the OHCA and interventions were described and associations with survival were determined.ResultsTwo hundred forty-two patients were included (73 % male, median age 65 years). In 76 % the cardiac arrest was of cardiac origin and 52 % had a shockable rhythm. In 74 % the cardiac arrest was witnessed, 76 % received bystander cardiopulmonary resuscitation and in 39 % an automatic external defibrillator (AED) was used. Of the 168 hospitalised patients, 144 underwent therapeutic procedures. A total of 105 patients survived until hospital discharge. Younger age, cardiac arrest in public area, witnessed cardiac arrest, cardiac origin with a shockable rhythm, the use of an AED, shorter time until return of spontaneous circulation, Glasgow Coma Scale (GCS) ≥13 during transport and longer length of hospital stay were associated with survival. Of the 105 survivors 72 survived for at least 1 year after cardiac arrest and 6 patients died.ConclusionA survival rate of 43 % after OHCA is achievable. Witnessed cardiac arrest, cardiac cause of arrest, initial cardiac rhythm and GCS ≥13 were associated with higher survival.

Analysis of out-of-hospital cardiac arrest in Croatia – survival, bystander cardiopulmonary resuscitation, and impact of physician’s experience on cardiac arrest management: a single center observational study

“…While numerous studies investigated survival rates after OHCA in different European countries, this is the first study investigating different features of OHCA resuscitation in Croatia, including the survival rate (3). Although our results are far from the survival rate of 43% in Netherlands (21) or 35% in Osaka Prefecture, Japan (22), the survival rate until discharge after OHCA of 14% in Varaždin County exceeds OHCA overall survival rate in Europe (9%) (1), part of Poland (10%) (23), or Czechia (9%) (24), with the latter two having similar cultural characteristics as Croatia. Such a good survival rate is probably due to the prompt response time of 6 minutes and physician-staffed EMS team, but we also showed that the survival rate to discharge was associated with the conduction of bystander CPR.…”

“…This bystander CPR rate is slightly higher than in Germany (19%) (25) or Slovenia (22%) (26). Despite of this, we feel that our goal should be set higher, toward the bystander CPR rates of about 40%, as is the case in the United States (27) and England (28), or 76% in the Netherlands (21). …”

Spectral analysis-based risk score enables early prediction of mortality and cerebral performance in patients undergoing therapeutic hypothermia for ventricular fibrillation and comatose status

“…However, our data is consistent with similar series in dedicated units that included patients after admission to the ACCU, with an initial rhythm reported as VF and using mild hypothermia [29,30]. Therefore, the study population may be skewed towards patients with FNP, since patients who died in transit or survived to hospital admission but died in the emergency department or during the hypothermia protocol, before withdrawing sedation, were excluded.…”

Knowledge and attitudes of Singapore schoolchildren learning cardiopulmonary resuscitation and automated external defibrillator skills

“…Such high rates are attributable to various prehospital improvements and public training initiatives. (14)(15)(16)(17)(18) Pertinent to our study, Norway, (19)(20)(21) Sweden (14,17) and Denmark, (15) for example, have successfully mandated various schoolbased CPR and AED trainings over the years as part of their overall strategy to improve OHCA survival outcomes. (5,15,(19)(20)(21) The success in Europe and Seattle (22) inspired Singapore to adopt a multifaceted approach to improve bystander CPR rates.…”