Marcus Eng Hock Ong1, Sang Do Shin2, Nurun Nisa Amatullah De Souza3, Hideharu Tanaka4, Tatsuya Nishiuchi5, Kyoung Jun Song2, Patrick Chow-In Ko6, Benjamin Sieu-Hon Leong7, Nalinas Khunkhlai8, Ghulam Yasin Naroo9, Abdul Karim Sarah10, Yih Yng Ng11, Wen Yun Li12, Matthew Huei-Ming Ma13. 1. Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore; Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore. Electronic address: marcus.ong.e.h@sgh.com.sg. 2. Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea. 3. Singapore Clinical Research Institute Pte Ltd, Singapore, Singapore; Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore. 4. Department of EMS System, Graduate School, Kokushikan University, Tokyo, Japan. 5. Department of Acute Medicine, Kindai University Faculty of Medicine, Osaka, Japan. 6. Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. 7. Emergency Medicine Department, National University Hospital, Singapore, Singapore. 8. Department of Emergency Medicine, Rajavithi Hospital, Bangkok, Thailand. 9. Department of Health & Medical Services, ED-Trauma Centre, Rashid Hospital, Dubai, United Arab Emirates. 10. Department of Emergency Medicine, Hospital Sungai Buloh, Sungai Buloh, Selangor, Malaysia. 11. Medical Department, Singapore Civil Defence Force, Singapore, Singapore. 12. Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore. 13. Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan, ROC.
Abstract
BACKGROUND: The Pan Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network (CRN) was established in collaboration with emergency medical services (EMS) agencies and academic centers in Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and UAE-Dubai and aims to report out-of-hospital cardiac arrests (OHCA) and provide a better understanding of OHCA trends in Asia. METHODS AND RESULTS: This is a prospective, international, multi-center cohort study of OHCA across the Asia-Pacific. Each participating country provided between 1.5 and 2.5 years of data from January 2009 to December 2012. All OHCA cases conveyed by EMS or presenting at emergency departments were captured. 66,780 OHCA cases were submitted to the PAROS CRN; 41,004 cases were presumed cardiac etiology. The mean age OHCA occurred varied from 49.7 to 71.7 years. The proportion of males ranged from 57.9% to 82.7%. Proportion of unwitnessed arrests ranged from 26.4% to 67.9%. Presenting shockable rhythm rates ranged from 4.1% to 19.8%. Bystander cardiopulmonary resuscitation (CPR) rates varied from 10.5% to 40.9%, however <1.0% of these arrests received bystander defibrillation. For arrests that were with cardiac etiology, witnessed arrest and VF, the survival rate to hospital discharge varied from no reported survivors to 31.2%. Overall survival to hospital discharge varied from 0.5% to 8.5%. Survival with good neurological function ranged from 1.6% to 3%. CONCLUSIONS: Survival to hospital discharge for Asia varies widely and this may be related to patient and system differences. This implies that survival may be improved with interventions such as increasing bystander CPR, public access defibrillation and improving EMS.
BACKGROUND: The Pan Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network (CRN) was established in collaboration with emergency medical services (EMS) agencies and academic centers in Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and UAE-Dubai and aims to report out-of-hospital cardiac arrests (OHCA) and provide a better understanding of OHCA trends in Asia. METHODS AND RESULTS: This is a prospective, international, multi-center cohort study of OHCA across the Asia-Pacific. Each participating country provided between 1.5 and 2.5 years of data from January 2009 to December 2012. All OHCA cases conveyed by EMS or presenting at emergency departments were captured. 66,780 OHCA cases were submitted to the PAROS CRN; 41,004 cases were presumed cardiac etiology. The mean age OHCA occurred varied from 49.7 to 71.7 years. The proportion of males ranged from 57.9% to 82.7%. Proportion of unwitnessed arrests ranged from 26.4% to 67.9%. Presenting shockable rhythm rates ranged from 4.1% to 19.8%. Bystander cardiopulmonary resuscitation (CPR) rates varied from 10.5% to 40.9%, however <1.0% of these arrests received bystander defibrillation. For arrests that were with cardiac etiology, witnessed arrest and VF, the survival rate to hospital discharge varied from no reported survivors to 31.2%. Overall survival to hospital discharge varied from 0.5% to 8.5%. Survival with good neurological function ranged from 1.6% to 3%. CONCLUSIONS: Survival to hospital discharge for Asia varies widely and this may be related to patient and system differences. This implies that survival may be improved with interventions such as increasing bystander CPR, public access defibrillation and improving EMS.
Authors: Chi Keong Ching; Siew Hon Benjamin Leong; Siang Jin Terrance Chua; Swee Han Lim; Kenneth Heng; Sohil Pothiawala; Venkataraman Anantharaman Journal: Singapore Med J Date: 2017-07 Impact factor: 1.858
Authors: Nausheen Edwin Doctor; Nur Shahidah Binte Ahmad; Pin Pin Pek; Susan Yap; Marcus Eng Hock Ong Journal: Singapore Med J Date: 2017-07 Impact factor: 1.858
Authors: Weiting Huang; Gary Kuan Wee Teo; Jack Wei-Chieh Tan; Nur Shahidah Ahmad; Hwee Hong Koh; Marcus Eng Hock Ong Journal: Heart Asia Date: 2018-06-15