Urban and rural differences in out-of-hospital cardiac arrest in Ireland

Masterson, Siobhán; Wright, P.J.; O’Donnell, Cathal; Vellinga, Akke; Murphy, Andrew W.; Hennelly, David; Sinnott, Brendan; Egan, Jonathan R.; O’Reilly, Martin; Keaney, John F.; Bury, Gerard; Deasy, Conor

doi:10.1016/j.resuscitation.2015.03.012

Cited by 74 publications

(64 citation statements)

References 37 publications

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“…Our results are consistent with those of previous studies documenting that survival is higher among OHCA patients in crowded areas, e.g. airports, than in rural areas 13 , 14 . The association between population density and survival remained significant in the multivariable analyses.…”

Section: Discussionsupporting

confidence: 92%

Distance to invasive heart centre, performance of acute coronary angiography, and angioplasty and associated outcome in out-of-hospital cardiac arrest: a nationwide study

Tranberg

Lippert

Christensen

et al. 2017

European Heart Journal

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AimsTo evaluate whether the distance from the site of event to an invasive heart centre, acute coronary angiography (CAG)/percutaneous coronary intervention (PCI) and hospital-level of care (invasive heart centre vs. local hospital) is associated with survival in out-of-hospital cardiac arrest (OHCA) patients.Methods and resultsNationwide historical follow-up study of 41 186 unselected OHCA patients, in whom resuscitation was attempted between 2001 and 2013, identified through the Danish Cardiac Arrest Registry. We observed an increase in the proportion of patients receiving bystander CPR (18% in 2001, 60% in 2013, P < 0.001), achieving return of spontaneous circulation (ROSC) (10% in 2001, 29% in 2013, P < 0.001) and being admitted directly to an invasive centre (26% in 2001, 45% in 2013, P < 0.001). Simultaneously, 30-day survival rose from 5% in 2001 to 12% in 2013, P < 0.001. Among patients achieving ROSC, a larger proportion underwent acute CAG/PCI (5% in 2001, 27% in 2013, P < 0.001). The proportion of patients undergoing acute CAG/PCI annually in each region was defined as the CAG/PCI index. The following variables were associated with lower mortality in multivariable analyses: direct admission to invasive heart centre (HR 0.91, 95% CI: 0.89–0.93), CAG/PCI index (HR 0.33, 95% CI: 0.25–0.45), population density above 2000 per square kilometre (HR 0.94, 95% CI: 0.89–0.98), bystander CPR (HR 0.97, 95% CI: 0.95–0.99) and witnessed OHCA (HR 0.87, 95% CI: 0.85–0.89), whereas distance to the nearest invasive centre was not associated with survival.ConclusionAdmission to an invasive heart centre and regional performance of acute CAG/PCI were associated with improved survival in OHCA patients, whereas distance to the invasive centre was not. These results support a centralized strategy for immediate post-resuscitation care in OHCA patients.

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Section: Discussionsupporting

confidence: 92%

Distance to invasive heart centre, performance of acute coronary angiography, and angioplasty and associated outcome in out-of-hospital cardiac arrest: a nationwide study

Tranberg

Lippert

Christensen

et al. 2017

European Heart Journal

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“…Recent publications describe a 30-day survival ranging from 20 to 31% in victims with witnessed cardiac arrest and VF. 11,27 In a longitudinal study from North America, an increasing number of survivors were found but also with variability within the participating systems. 28 In relation to these outcome differences, we might assume differences in bystander-CPR, quality of CPR and post-ROSC treatment in our study group within the different countries and systems.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6] During the last decades a number of registries for OHCA have been implemented in Europe. [7][8][9][10][11][12][13][14][15][16][17] These registries cover varied parts of the participating countries. The greater part of Europe however is not included in a registry with the aim of continuous reporting of OHCA.…”

Section: Introductionmentioning

confidence: 99%

EuReCa ONE⿿27 Nations, ONE Europe, ONE Registry

Gräsner¹,

Lefering²,

Koster³

et al. 2016

Resuscitation

555

114

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The results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe. EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events.

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“…CFR programmes are not widely available in Ireland at present. Expansion of this integrated community response system is being actively worked on and should improve bystander CPR rates and reduce the elapsed time from cardiac arrest recognition to first defibrillation 23. Smart phone applications such as GoodSAM (Smartphone Activated Medics) offer further promise in reducing the elapsed time to initiation of CPR and defibrillation after an OHCA is identified 24.…”

Section: Discussionmentioning

confidence: 99%