Eujene Jung1, Jeong Ho Park2, So Yeon Kong3, Ki Jeong Hong4, Young Sun Ro3, Kyoung Jun Song2, Hyun Ho Ryu5, Sang Do Shin2. 1. Department of Emergency Medicine, Chonnam National University Hospital, Gwang-ju, Republic of Korea. 2. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. 3. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Institute, Seoul, Republic of Korea. 4. Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. 5. Department of Emergency Medicine, Chonnam National University Hospital, Gwang-ju, Republic of Korea. Electronic address: oriryu@cnuh.com.
Abstract
BACKGROUND: Previous studies on cardiac arrest in mountainous areas were focused on environmental features such as altitude and temperature. However, those are limited to factors affecting the prognosis of patients after cardiac arrest. We analyzed the cardiac arrests in national or provincial parks located in the mountains and determined the factors affecting the prognosis of patients after cardiac arrest. METHODS: This study included all emergency medical service (EMS) treated patients over the age of 40 experiencing out-of-hospital cardiac arrests (OHCAs) of presumed cardiac etiology during exercise, between January 2012 and December 2015. The main focus of interest was the location of cardiac arrest occurrence (national mountain parks and provincial parks vs. other sites). The main outcome was survival to discharge and multivariable logistic regression was performed to adjust for possible confounding effects. RESULTS: A total 1835 patients who suffered a cardiac arrest while exercising were included. From these, 68 patients experienced cardiac arrest in national or provincial parks, and 1767 occurred in other locations. The unadjusted and adjusted ORs (95% CI) for a good cerebral performance scale (CPC) were 0.09 (0.01-0.63) and 0.08(0.01-0.56), survival discharges were 0.13(0.03-0.53) and 0.11 (0.03-0.48). CONCLUSIONS: Cardiac arrests occurring while exercising in the mountainous areas have worse prognosis compared to alternative locations.
BACKGROUND: Previous studies on cardiac arrest in mountainous areas were focused on environmental features such as altitude and temperature. However, those are limited to factors affecting the prognosis of patients after cardiac arrest. We analyzed the cardiac arrests in national or provincial parks located in the mountains and determined the factors affecting the prognosis of patients after cardiac arrest. METHODS: This study included all emergency medical service (EMS) treated patients over the age of 40 experiencing out-of-hospital cardiac arrests (OHCAs) of presumed cardiac etiology during exercise, between January 2012 and December 2015. The main focus of interest was the location of cardiac arrest occurrence (national mountain parks and provincial parks vs. other sites). The main outcome was survival to discharge and multivariable logistic regression was performed to adjust for possible confounding effects. RESULTS: A total 1835 patients who suffered a cardiac arrest while exercising were included. From these, 68 patients experienced cardiac arrest in national or provincial parks, and 1767 occurred in other locations. The unadjusted and adjusted ORs (95% CI) for a good cerebral performance scale (CPC) were 0.09 (0.01-0.63) and 0.08(0.01-0.56), survival discharges were 0.13(0.03-0.53) and 0.11 (0.03-0.48). CONCLUSIONS:Cardiac arrests occurring while exercising in the mountainous areas have worse prognosis compared to alternative locations.