Damien Viglino1, Maxime Maignan2, Arnaud Michalon3, Julien Turk4, Sarah K Buse5, Marc Blancher5, Tom P Aufderheide6, Loïc Belle7, Dominique Savary3, François-Xavier Ageron3, Guillaume Debaty8. 1. University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France; University Grenoble Alps - HP2 Laboratory INSERM U1042, Grenoble, France. Electronic address: dviglino@chu-grenoble.fr. 2. University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France; University Grenoble Alps - HP2 Laboratory INSERM U1042, Grenoble, France. 3. Annecy-Genevois Hospital, Emergency Department and Mobile Intensive Care Unit, Annecy, France. 4. Chambery Metropole Savoie Hospital, Emergency Department and Mobile Intensive Care Unit, Chambery, France. 5. University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France. 6. Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, United States. 7. Annecy-Genevois Hospital, Cardiac Intensive Care Unit, Annecy, France. 8. University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France; University Grenoble Alps - TIMC-IMAG laboratory Team PRETA CNRS UMR 5525, Grenoble, France.
Abstract
AIM: Intense physical activity, cold and altitude make mountain sports a cause of increased risk of out-of-hospital cardiac arrest (OHCA). The difficulties of pre-hospital management related to this challenging environment could be mitigated by the presence of ski-patrollers in ski areas and use of helicopters for medical rescue. We assess whether this particular situation positively impacts the chain of survival compared to the general population. METHODS: Analysis of prospectively collected data from the cardiac arrest registry of the Northern French Alps Emergency Network (RENAU) from 2004 to 2014. RESULTS: 19,341 OHCAs were recorded during the period, including 136 on-slope events. Compared to other OHCAs, on-slope patients were younger (56 [40-65] vs. 66 [52-79] years, p<0.001) and more often in shockable initial rhythm (41.2% vs 20.1%, p<0.001). Resuscitation was more frequently started by a witness (43.4% vs 26.8%, p<0.001) and the time to the first electric shock was shorter (7.5min vs 14min, p<0.001), whereas time to the advanced life support (ALS) rescue arrival did not differ. The 30-day survival rate was higher for on-slope arrests (21.3% vs 5.9%, p<0.001, RR=3.61). In multivariate analysis, on-slope CA remained a positive 30-day survival factor with a 2.6 odds ratio (95% confidence interval, 1.42-4.81, p=0.002). CONCLUSION: Despite difficult access and management conditions, patients undergoing OHCAs on ski slopes presented a higher survival rate, possibly explained by a healthier population, the efficiency of resuscitation by ski-patrols and similar time to ALS facilities compared to other cardiac arrests.
AIM: Intense physical activity, cold and altitude make mountain sports a cause of increased risk of out-of-hospital cardiac arrest (OHCA). The difficulties of pre-hospital management related to this challenging environment could be mitigated by the presence of ski-patrollers in ski areas and use of helicopters for medical rescue. We assess whether this particular situation positively impacts the chain of survival compared to the general population. METHODS: Analysis of prospectively collected data from the cardiac arrest registry of the Northern French Alps Emergency Network (RENAU) from 2004 to 2014. RESULTS: 19,341 OHCAs were recorded during the period, including 136 on-slope events. Compared to other OHCAs, on-slope patients were younger (56 [40-65] vs. 66 [52-79] years, p<0.001) and more often in shockable initial rhythm (41.2% vs 20.1%, p<0.001). Resuscitation was more frequently started by a witness (43.4% vs 26.8%, p<0.001) and the time to the first electric shock was shorter (7.5min vs 14min, p<0.001), whereas time to the advanced life support (ALS) rescue arrival did not differ. The 30-day survival rate was higher for on-slope arrests (21.3% vs 5.9%, p<0.001, RR=3.61). In multivariate analysis, on-slope CA remained a positive 30-day survival factor with a 2.6 odds ratio (95% confidence interval, 1.42-4.81, p=0.002). CONCLUSION: Despite difficult access and management conditions, patients undergoing OHCAs on ski slopes presented a higher survival rate, possibly explained by a healthier population, the efficiency of resuscitation by ski-patrols and similar time to ALS facilities compared to other cardiac arrests.
Authors: Markus Posch; Johannes Burtscher; Gerhard Ruedl; Elena Pocecco; Martin Burtscher Journal: Int J Environ Res Public Health Date: 2022-06-24 Impact factor: 4.614
Authors: Martin Burtscher; Urs Hefti; Gerhard Ruedl; Jacqueline Pichler Hefti Journal: Int J Environ Res Public Health Date: 2022-08-02 Impact factor: 4.614