The Dublin cardiac arrest registry: temporal improvement in survival from out-of-hospital cardiac arrest reflects improved pre-hospital emergency care

Abstract

The incidence of OOHCA has declined but importantly, survival to hospital discharge has improved dramatically. Reduction in ambulance response time, resulting in earlier initiation of basic and advanced life support and earlier defibrillation, was associated with an increase in the proportion of victims found in VF rather than asystole and likely accounted for most of the improvement. Further improvements in response times and public education to improve bystander CPR rates should remain a priority.

Epidemiology of out-of-hospital cardiac arrest in the Bielsko-Biala district: a 12-month analysis

“…Also, in respect of OHCA reporting requirements, numerous studies still apply rates that are unadjusted to the age or gender of the population, and the reporting according to Utstein criteria is suboptimal in many aspects [10]. This inconsistency, described in our study, needs to be additionally emphasised between incidences for women and men [8,11] -the rates are twice as low for women. It has been confirmed that women who suffered from OHCA are usually older and burdened with several comorbidities.…”

“…Comparing the data with literature, a significant discrepancy can be noted, especially with the countries of Western Europe where the numbers are two or three times lower [2]. On the basis of international data, the standard OHCA incidence rate ranges from 34/100,000 (Denmark) [5], through 51/100,000 (Finland) [6], 52/100,000 (Sweden) [7], and 88/100,000 (Ireland), [8] to 206/100,000 (Austria) [9]. These detectable differences can be explained by two major facts: on the one hand, it is related to the characteristics of patients and circumstances of the incident, and on the other hand, to the system of reporting results.…”

“…An extreme exception is described by the data from Beijing (China), where CPR was undertaken in only 25% of OHCA incidents, and only 11.4% by a witness of the incident [22]. The low rate of CPR attempts undertaken by witnesses was also described in a few European studies [8,20,21], including Polish ones [14,15]. This is especially important because early undertaking of basic lifesaving activities by witnesses and then advanced lifesaving actions by EMS teams are basic links in the chain of survival and, at the same time, important factors that increase the chance for the procedures undertaken in OHCA to be successful [1].…”

“…Moreover, the described circumstances of OHCA are consistent: cardiac arrest usually occurs at home (60-80%) in the presence of witnesses (up to 90%) and with other mechanisms than VT/VF (up to 90%) [8,11,[14][15][16][18][19][20][21]. CPR is undertaken by approximately half of the witnesses.…”

Sudden death and cardiac arrest without phenotype: the utility of genetic testing

“…The prevalence of SCD is 50,000-100,000 pa in the UK, of which up to 4% may be 'unexplained' (1). The finding of a morphologically normal heart on autopsy is common in most series of young SCD (2)(3)(4)(5)(6)(7)(8). Unexplained sudden death of an individual older than 1 year of age with negative pathological and toxicological assessment on autopsy is referred to as sudden arrhythmic death syndrome (SADS) (9).…”