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

作者：Boyce L W^*; Vlieland T P M Vliet; Bosch J; Wolterbeek R; Volker G; van Exel H J; Heringhaus C; Schalij M J; Goossens P H

来源：Netherlands Heart Journal, 2015, 23(1): 20-25.

DOI：10.1007/s12471-014-0617-x

• Out of hospital cardiac arrest
• Survival
• Cardiopulmonary resuscitation

Aims Survival 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.
Methods Consecutive 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.
Results Two 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.
Conclusion A 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.

• 出版日期2015-1