Tan N Doan1, Brendan V Schultz2, Stephen Rashford3, Emma Bosley4. 1. Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, Queensland, Australia; Department of Medicine at The Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia. Electronic address: tan.doan@ambulance.qld.gov.au. 2. Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, Queensland, Australia. 3. Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, Queensland, Australia; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia. 4. Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, Queensland, Australia; School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
Abstract
BACKGROUND: Substantial variations exist in relation to the characteristics and outcomes of out-of-hospital cardiac arrest (OHCA). As such, an understanding of region-specific factors is essential for informing strategies to improve OHCA survival. METHODS: Analysis of a large state-wide OHCA database of the Queensland Ambulance Service, Australia. Adult patients, attended by paramedics between January 2000 and December 2018 for OHCA of medical origin, where the arrest was not witnessed by paramedics, and resuscitation was attempted, were included. Factors associated with survival were investigated. The number needed to treat (NNT) for bystander interventions was estimated. RESULTS: Across a total of 23,510 patients, event survival, survival to discharge and 30-day survival was 22.6%, 11.9% and 11.5%, respectively. The corresponding figures for the Utstein patient group (initial shockable rhythm, bystander-witnessed) were 38.9%, 27.2% and 26.3%, respectively. Bystander cardiopulmonary resuscitation (CPR) and defibrillation substantially improved the likelihood of survival. The NNT for bystander CPR was 41, 63 and 64 for event survival, survival to discharge, and 30-day survival, respectively. The NNT for bystander defibrillation for these survival outcomes was 10, 14 and 14, respectively. CONCLUSIONS: Bystander interventions are critical for OHCA survival. Effort should be invested in strategies to improve the uptake of these interventions.
BACKGROUND: Substantial variations exist in relation to the characteristics and outcomes of out-of-hospital cardiac arrest (OHCA). As such, an understanding of region-specific factors is essential for informing strategies to improve OHCA survival. METHODS: Analysis of a large state-wide OHCA database of the Queensland Ambulance Service, Australia. Adult patients, attended by paramedics between January 2000 and December 2018 for OHCA of medical origin, where the arrest was not witnessed by paramedics, and resuscitation was attempted, were included. Factors associated with survival were investigated. The number needed to treat (NNT) for bystander interventions was estimated. RESULTS: Across a total of 23,510 patients, event survival, survival to discharge and 30-day survival was 22.6%, 11.9% and 11.5%, respectively. The corresponding figures for the Utstein patient group (initial shockable rhythm, bystander-witnessed) were 38.9%, 27.2% and 26.3%, respectively. Bystander cardiopulmonary resuscitation (CPR) and defibrillation substantially improved the likelihood of survival. The NNT for bystander CPR was 41, 63 and 64 for event survival, survival to discharge, and 30-day survival, respectively. The NNT for bystander defibrillation for these survival outcomes was 10, 14 and 14, respectively. CONCLUSIONS: Bystander interventions are critical for OHCA survival. Effort should be invested in strategies to improve the uptake of these interventions.
Authors: William J Brady; Summer Chavez; Michael Gottlieb; Stephen Y Liang; Brandon Carius; Alex Koyfman; Brit Long Journal: Am J Emerg Med Date: 2022-04-27 Impact factor: 4.093
Authors: Carsten Lott; Anatolij Truhlář; Anette Alfonzo; Alessandro Barelli; Violeta González-Salvado; Jochen Hinkelbein; Jerry P Nolan; Peter Paal; Gavin D Perkins; Karl-Christian Thies; Joyce Yeung; David A Zideman; Jasmeet Soar Journal: Notf Rett Med Date: 2021-06-10 Impact factor: 0.826