Epidemiology and outcomes of out-of-hospital cardiac arrest in Rochester, New York

Division of General Medicine, University of Rochester, Rochester, New York, United States
Resuscitation (Impact Factor: 4.17). 04/2007; 72(3):415-24. DOI: 10.1016/j.resuscitation.2006.06.135
Source: PubMed


To characterize out-of-hospital cardiac arrest (OHCA) and factors that affect survival in a medium sized city that uses system status management for dispatch.
A retrospective cohort study of all adult OHCA patients treated by EMS between 1998 and 2001 was conducted using Utstein definitions. The primary endpoint was 1-year survival.
Of the 1177 patients who experienced OHCA during the study period, 539 (46%) met inclusion criteria. Age ranged from 18 to 98 years (median 67). The median call-response interval was 5 min (range 0-21), and 93% were 9 min or less. There was no significant difference in the median call-response intervals between call location zip (Post) codes (p=0.07). Twenty percent of experienced ROSC (95% CI 17-23), 7% survived more than 30 days (95% CI 5-9%), and 5% survived to 1 year (95% CI 3-7%). In bivariate analysis, first rhythm and bystander CPR affected survival to 1 year. There was no significant difference in survival between male (4%) and female (7%), black (4%) and white (6%), or witnessed (7%) and unwitnessed arrest (4%). Logistic regression identified younger age, CPR initiated by bystander (19%) or first responder (41%), and presenting rhythm of VF/VT (32%) as factors associated with survival to 1 year.
This study finds a 5% survival to 1 year among OHCA patients in Rochester, NY. A presenting rhythm of VF/VT and bystander CPR were associated with increased survival.

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    • "Male patients were less likely to survive then females in both univariate and multivariate analysis. This is in contrast to previous studies which did not show difference in outcome with respect to gender.[1315–18] "
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    ABSTRACT: The aim of this study was to demonstrate that APACHE II scores can be used as a predictor of the cardio-pulmonary resuscitation (CPR) outcome in hospitalized patients. A retrospective chart review of patients admitted, from 2002 to 2007, at the Aga Khan University Hospital, Karachi, was done for this study. Information was collected on 738 patients, constituting all adults admitted in general ward, ICU, CICU and SCU during this time, and who had under-went cardiac arrest and received cardiopulmonary resuscitation during their stay at the hospital. Patient characteristics, intra-arrest variables such as event-witnessed, initial cardiac rhythm, pre arrest need for intubation and vasoactive drugs, duration of CPR and survival details were extracted from patient records. The APACHE II score was calculated for each patient and a descriptive analysis was done for demographic and clinical features. The primary outcome of successful CPR was categorized as survival >24 h after CPR versus survival <24 h after CPR. Multivariable logistic regression was used to assess the association between the explanatory variables and successful CPR. Patients with APACHE II scores less than 20 had 4.6 times higher odds of survival compared to patients with a score of >35 (AOR: 4.6, 95% CI: 2.4-9.0). Also, shorter duration of CPR (AOR: 2.9, 95% CI: 1.9-4.4), evening shift (AOR: 2.1, 95% CI: 1.3-3.5) and Male patients (AOR: 0.6, 95% CI: (0.4-0.9) compared to females were other significant predictors of CPR outcome. APACHE II score, along with other patient characteristics, should be considered in clinical decisions related to CPR administration.
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    • "Overall survival rate from out-of-hospital cardiac arrest has not increased in parallel with the improvements in cardiopulmonary resuscitation (CPR) [1,2]. The hospital discharge rate is 15% in a meta-analysis that included a total population of over 26,000 patients [3]. "
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    Full-text · Article · Mar 2010 · Critical care (London, England)
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    • "In the literature age remains a controversial variable in predicting outcome. Many studies [10–12, 15, 16] support the idea that it can predict outcome while others [17–21] argue that age per se does not exert any significant effect on the outcome of cardiac arrest and should not be used as a criterion to make the decision about the potential benefits of CPR. Our study complemented other studies which did not observe any difference in outcome with respect to gender of the victim [5, 8, 14–16]. "
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