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

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.

[1]  H. Tan,et al.  Implantable Cardioverter-Defibrillators Have Reduced the Incidence of Resuscitation for Out-of-Hospital Cardiac Arrest Caused by Lethal Arrhythmias , 2012, Circulation.

[2]  D. Stub,et al.  Hospital characteristics are associated with patient outcomes following out-of-hospital cardiac arrest , 2011, Heart.

[3]  Benjamin S. Abella,et al.  Circ Cardiovasc Qual Outcomes , 2013 .

[4]  Arthur L. Kellermann,et al.  Predictors of Survival From Out-of-Hospital Cardiac Arrest A Systematic Review and Meta-Analysis , 2013 .

[5]  R. Neumar,et al.  Emergency department factors associated with survival after sudden cardiac arrest. , 2013, Resuscitation.

[6]  Niels Peek,et al.  Cardiac rehabilitation uptake and its determinants in the Netherlands , 2013, European journal of preventive cardiology.

[7]  S. Brett,et al.  Clinical review: Beyond immediate survival from resuscitation – long-term outcome considerations after cardiac arrest , 2007, Critical care.

[8]  Daniel Davis,et al.  Survival after application of automatic external defibrillators before arrival of the emergency medical system: evaluation in the resuscitation outcomes consortium population of 21 million. , 2010, Journal of the American College of Cardiology.

[9]  R. Berg,et al.  Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. , 2010, Resuscitation.

[10]  A. Six,et al.  Consumption of diagnostic procedures and other cardiology care in chest pain patients after presentation at the emergency department , 2012, Netherlands Heart Journal.

[11]  R W Koster,et al.  Out-of-hospital cardiac arrests in Amsterdam and its surrounding areas: results from the Amsterdam resuscitation study (ARREST) in 'Utstein' style. , 1998, Resuscitation.

[12]  H. Tan,et al.  Impact of Onsite or Dispatched Automated External Defibrillator Use on Survival After Out-of-Hospital Cardiac Arrest , 2011, Circulation.