• Am J Emerg Med · Sep 2017

    Multicenter Study Observational Study

    Features of hospital and emergency medical service in out-of-hospital cardiac arrest patients with shockable rhythm.

    • Shang-Li Tsai, Chung-Hsien Chaou, Chien-Hsiung Huang, I-Shiang Tzeng, Chan-Wei Kuo, Yi-Ming Weng, and Cheng-Yu Chien.
    • Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, 5 Fuxing Street, Guishan District, Taoyuan 333, Taiwan.
    • Am J Emerg Med. 2017 Sep 1; 35 (9): 1222-1227.

    ObjectivePredicting the outcome of out-of-hospital cardiac arrest (OHCA) patients is crucial. We examined hospital characteristics and parameters of emergency medical service (including scene time interval and direct ambulance delivery to intensive heart hospitals) as survival or outcome predictors.Study DesignData from 546 consecutive OHCA shockable patients treated between January 2012 and December 2015 in Taoyuan City (Taiwan, ROC) were collected. In addition to demographic data, location of arrest, initial rhythm, availability of a hospital with or without 24/7 percutaneous coronary intervention (PCI), emergency medical service (EMS) time, provision of cardiopulmonary resuscitation by a bystander, presence of a witness at collapse, and level of life support were analysed.ResultsMultivariate analysis showed that hospitalisation with immediate PCI availability was an independent predictor (OR: 4.32; 95% CI: 1.27-14.70) solely for the outcome of survival until discharge. The presence of a witness while collapsing (OR: 3.52; 95% CI: 1.03-11.98), EMS response time (OR: 0.83; 95% CI: 0.70-0.98), and scene time interval (STI; OR: 0.89; 95% CI: 0.81-0.99) were valuable for predicting the neurological outcome.ConclusionsDirect ambulance delivery to intensive heart hospitals that had 24/7 PCI availability was associated with a higher probability of surviving until discharge in OHCA patients with shockable rhythms. Similarly, a witnessed collapse was correlated with being discharged alive from hospital and recovering with good cerebral performance. In addition, longer response time and scene time interval indicated poorer survival and neurological outcome.Copyright © 2017 Elsevier Inc. All rights reserved.

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