Jan-Thorsten Gräsner1, Jan Wnent2, Johan Herlitz3, Gavin D Perkins4, Rolf Lefering5, Ingvild Tjelmeland6, Rudolph W Koster7, Siobhán Masterson8, Fernando Rossell-Ortiz9, Holger Maurer10, Bernd W Böttiger11, Maximilian Moertl12, Pierre Mols13, Hajriz Alihodžić14, Irzal Hadžibegović15, Marios Ioannides16, Anatolij Truhlář17, Mads Wissenberg18, Ari Salo19, Josephine Escutnaire20, Nikolaos Nikolaou21, Eniko Nagy22, Bergthor Steinn Jonsson23, Peter Wright24, Federico Semeraro25, Carlo Clarens26, Steffie Beesems27, Grzegorz Cebula28, Vitor H Correia29, Diana Cimpoesu30, Violetta Raffay31, Stefan Trenkler32, Andrej Markota33, Anneli Strömsöe34, Roman Burkart35, Scott Booth36, Leo Bossaert37. 1. University-Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany; University-Hospital Schleswig-Holstein, Department of Anesthesiology and Intensive Care Medicine, Kiel, Germany. Electronic address: jan-thorsten.graesner@uksh.de. 2. University-Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany; University-Hospital Schleswig-Holstein, Department of Anesthesiology and Intensive Care Medicine, Kiel, Germany; University of Namibia, School of Medicine, Windhoek, Namibia. 3. Prehospen-Centre for Prehospital Research, Faculty of Caring Science, Work-Life and Social Welfare, University of Borås, Borås, Sweden. 4. Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom; University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. 5. Institut Für Forschung in Der Operativen Medizin (IFOM), Abteilung Statistik Und Registerforschung, Universität Witten/Herdecke, Germany. 6. Oslo University Hospital, Division of Prehospital Services, Norway; University-Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany. 7. Department of Cardiology, Amsterdam UMC, Location Academic Medical Center, Amsterdam, The Netherlands. 8. Discipline of General Practice, National University of Ireland Galway (on Behalf of the Out-of-Hospital Cardiac Arrest Register (OHCAR)) and the HSE National Ambulance Service, Ireland. 9. Empresa Pública de Emergencias Sanitarias de Andalucía, Spain. 10. University Hospital Schleswig-Holstein, Department of Anesthesiology and Intensive Care Medicine, Lübeck, Germany. 11. Professor and Head of the Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany; European Resuscitation Council (ERC), Niel, Belgium. 12. Department of Anaesthesia and Intensive Care, Universitätsklinik Innsbruck, Innsbruck, Austria. 13. Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Belgium. 14. Emergency Medical Service, Public Institution Health Centre 'Dr. Mustafa Šehović' and Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina. 15. University Hospital Dubrava Zagreb, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University Osijek, Croatia. 16. Nicosia General Hospital, Cyprus. 17. Emergency Medical Services of the Hradec Králové Region, Hradec Králové, Czech Republic; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Hradec Králové, Hradec Králové, Czech Republic. 18. Emergency Medical Services Copenhagen, University of Copenhagen, Denmark. 19. Emergency Medical Services, Department of Emergency Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 20. Univ. Lille, CHU Lille, EA 2694 - Santé Publique: épidémiologie et qualité des soins, F-59000 Lille, France. 21. Cardiology Department and ICCU, Konstantopouleio General Hospital, Athens, Greece. 22. Hungarian Resuscitation Council, Emergency Department University of Szeged, Hungary. 23. Department of Emergency Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. 24. HSE National Ambulance Service and National University of Ireland Galway, Ireland. 25. Department of Anaesthesia, Intensive Care and Emergency Medical Services, Ospedale Maggiore, Bologna, Italy. 26. Secretary of Luxembourg Resuscitation Council, Luxembourg. 27. Amsterdam UMC, Academic Medical Center, Heart Center, Department of Cardiology, Amsterdam, The Netherlands. 28. Jagiellonian University Medical College, Faculty of Medicine, Department of Medical Education, Poland. 29. Emergency Medical Service - SEMER/EMIR, Funchal, Portugal. 30. University of Medicine and Pharmacy Gr.T. Popa Iasi, Emergency Department, Emergency County Hospital Sf. Spiridon, Iasi, Romania. 31. Serbian Resuscitation Council, Novi Sad, Serbia. 32. P. J. Safarik University, Medical Faculty, L. Pasteur University Hospital, Department of Anaesthesiology and Intensive Medicine, Kosice, Slovakia. 33. Medical Intensive Care Unit, University Medical Centre Maribor, Maribor, Slovenia; Slovenian Resuscitation Council, Slovenian Society for Emergency Medicine, Ljubljana, Slovenia. 34. Department of Prehospital Care, County Council of Dalarna, Falun, Sweden; Centre for Clinical Research, Falun, Dalarna, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden. 35. Interassociation of Rescue Services, Bern, Switzerland. 36. Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom. 37. University of Antwerp, Antwerp, Belgium; European Resuscitation Council (ERC), Niel, Belgium.
Abstract
BACKGROUND: The epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) varies across Europe. Following on from EuReCa ONE, the aim of this study was to further explore the incidence of and outcomes from OHCA in Europe and to improve understanding of the role of the bystander. METHODS: This prospective, multicentre study involved the collection of registry-based data over a three-month period (1st October 2017 to 31st December 2017). The core study dataset complied with the Utstein-style. Primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital admission. Secondary outcome was survival to hospital discharge. RESULTS: All 28 countries provided data, covering a total population of 178,879,118. A total of 37,054 OHCA were confirmed, with CPR being started in 25,171 cases. The bystander cardiopulmonary resuscitation (CPR) rate ranged from 13% to 82% between countries (average: 58%). In one third of cases (33%) ROSC was achieved and 8% of patients were discharged from hospital alive. Survival to hospital discharge was higher in patients when a bystander performed CPR with ventilations, compared to compression-only CPR (14% vs. 8% respectively). CONCLUSION: In addition to increasing our understanding of the role of bystander CPR within Europe, EuReCa TWO has confirmed large variation in OHCA incidence, characteristics and outcome, and highlighted the extent to which OHCA is a public health burden across Europe. Unexplained variation remains and the EuReCa network has a continuing role to play in improving the quality management of resuscitation.
BACKGROUND: The epidemiology and outcome after out-of-hospital cardiac arrest (OHCA) varies across Europe. Following on from EuReCa ONE, the aim of this study was to further explore the incidence of and outcomes from OHCA in Europe and to improve understanding of the role of the bystander. METHODS: This prospective, multicentre study involved the collection of registry-based data over a three-month period (1st October 2017 to 31st December 2017). The core study dataset complied with the Utstein-style. Primary outcomes were return of spontaneous circulation (ROSC) and survival to hospital admission. Secondary outcome was survival to hospital discharge. RESULTS: All 28 countries provided data, covering a total population of 178,879,118. A total of 37,054 OHCA were confirmed, with CPR being started in 25,171 cases. The bystander cardiopulmonary resuscitation (CPR) rate ranged from 13% to 82% between countries (average: 58%). In one third of cases (33%) ROSC was achieved and 8% of patients were discharged from hospital alive. Survival to hospital discharge was higher in patients when a bystander performed CPR with ventilations, compared to compression-only CPR (14% vs. 8% respectively). CONCLUSION: In addition to increasing our understanding of the role of bystander CPR within Europe, EuReCa TWO has confirmed large variation in OHCA incidence, characteristics and outcome, and highlighted the extent to which OHCA is a public health burden across Europe. Unexplained variation remains and the EuReCa network has a continuing role to play in improving the quality management of resuscitation.
Authors: Jasmeet Soar; Bernd W Böttiger; Pierre Carli; Keith Couper; Charles D Deakin; Therese Djärv; Carsten Lott; Theresa Olasveengen; Peter Paal; Tommaso Pellis; Gavin D Perkins; Claudio Sandroni; Jerry P Nolan Journal: Notf Rett Med Date: 2021-06-08 Impact factor: 0.826
Authors: Spyros D Mentzelopoulos; Keith Couper; Patrick Van de Voorde; Patrick Druwé; Marieke Blom; Gavin D Perkins; Ileana Lulic; Jana Djakow; Violetta Raffay; Gisela Lilja; Leo Bossaert Journal: Notf Rett Med Date: 2021-06-02 Impact factor: 0.826
Authors: Enikő Kovács; Valéria Anna Gyarmathy; Dávid Pilecky; Alexandra Fekete-Győr; Zsófia Szakál-Tóth; László Gellér; Balázs Hauser; János Gál; Béla Merkely; Endre Zima Journal: Int J Environ Res Public Health Date: 2021-05-14 Impact factor: 3.390