S Schnaubelt1, K G Monsieurs2, F Semeraro3, J Schlieber4, A Cheng5, B L Bigham6, R Garg7, J C Finn8, R Greif9. 1. Department of Emergency Medicine, Medical University of Vienna, Austria. Electronic address: sebastian.schnaubelt@muv.ac.at. 2. Department of Emergency Medicine, Antwerp University Hospital and University of Antwerp, Belgium. 3. Department of Anaesthesia, Intensive Care and EMS, Maggiore Hospital Bologna, Italy. 4. Department of Anaesthesia and Intensive Care, Allgemeine Unfallversicherungsanstalt, Trauma Centre Salzburg, Salzburg, Austria. 5. Departments of Paediatrics and Emergency Medicine, University of Calgary, Calgary, Canada. 6. Department of Medicine, Stanford University, CA, USA. 7. Department of Onco-Anaesthesia and Palliative Medicine, Dr Braich, All India Institute of Medical Sciences, New Delhi, India. 8. Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Australia. 9. Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Switzerland; School of Medicine, Sigmund Freud University Vienna, Vienna, Austria.
Abstract
AIM OF THE SCOPING REVIEW: Scientific recommendations on resuscitation are typically formulated from the perspective of an ideal resource environment, with little consideration of applicability in lower-income countries. We aimed to determine clinical outcomes from out-of-hospital cardiac arrest (OHCA) in low-resource countries, to identify shortcomings related to resuscitation in these areas and possible solutions, and to suggest future research priorities. DATA SOURCES: This scoping review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR), and was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We identified low-resource countries as countries with a low- or middle gross national income per capita (World Bank data). We performed a literature search on outcomes after OHCA in these countries, and we extracted data on the outcome. We applied descriptive statistics and conducted a post-hoc correlation analysis of cohort size and ROSC rates. RESULTS: We defined 24 eligible studies originating from middle-income countries, but none from low-income regions, suggesting a reporting bias. The number of reported patients in these studies ranged from 54 to 3214. Utstein-style reporting was rarely used. Return of spontaneous circulation varied from 0% to 62%. Fifteen studies reported on survival to hospital discharge (between 1.0 and 16.7%) or favourable neurological outcome (between 1.0 and 9.3%). An inverse correlation was found for study cohort size and the rate of return of spontaneous circulation (ρ = -0.48, p = 0.034). CONCLUSION: Studies of OHCA outcomes in low-resource countries are heterogeneous and may be compromised by reporting bias. Minimum cardiopulmonary resuscitation standards for low-resource settings should be developed collaboratively involving local experts, respecting culture and context while balancing competing health priorities.
AIM OF THE SCOPING REVIEW: Scientific recommendations on resuscitation are typically formulated from the perspective of an ideal resource environment, with little consideration of applicability in lower-income countries. We aimed to determine clinical outcomes from out-of-hospital cardiac arrest (OHCA) in low-resource countries, to identify shortcomings related to resuscitation in these areas and possible solutions, and to suggest future research priorities. DATA SOURCES: This scoping review was part of the continuous evidence evaluation process of the International Liaison Committee on Resuscitation (ILCOR), and was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We identified low-resource countries as countries with a low- or middle gross national income per capita (World Bank data). We performed a literature search on outcomes after OHCA in these countries, and we extracted data on the outcome. We applied descriptive statistics and conducted a post-hoc correlation analysis of cohort size and ROSC rates. RESULTS: We defined 24 eligible studies originating from middle-income countries, but none from low-income regions, suggesting a reporting bias. The number of reported patients in these studies ranged from 54 to 3214. Utstein-style reporting was rarely used. Return of spontaneous circulation varied from 0% to 62%. Fifteen studies reported on survival to hospital discharge (between 1.0 and 16.7%) or favourable neurological outcome (between 1.0 and 9.3%). An inverse correlation was found for study cohort size and the rate of return of spontaneous circulation (ρ = -0.48, p = 0.034). CONCLUSION: Studies of OHCA outcomes in low-resource countries are heterogeneous and may be compromised by reporting bias. Minimum cardiopulmonary resuscitation standards for low-resource settings should be developed collaboratively involving local experts, respecting culture and context while balancing competing health priorities.
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: David O Alao; Nada A Mohammed; Yaman O Hukan; Maitha Al Neyadi; Zia Jummani; Emad H Dababneh; Arif A Cevik Journal: Resusc Plus Date: 2022-03-19
Authors: Sebastian Schnaubelt; Benedikt Schnaubelt; Arnold Pilz; Julia Oppenauer; Erdem Yildiz; Christoph Schriefl; Florian Ettl; Mario Krammel; Rakesh Garg; Alexander Niessner; Robert Greif; Hans Domanovits; Patrick Sulzgruber Journal: Eur J Clin Invest Date: 2021-07-10 Impact factor: 5.722