Improvement in Non‐Traumatic, Out‐Of‐Hospital Cardiac Arrest Survival in Detroit From 2014 to 2016
Background In 2002, the out‐of‐hospital cardiac arrest (OHCA) survival rate in Detroit was the lowest in the nation. Concerted efforts sought to improve the city's chain of survival with a focus on emergency medical services (EMS). This study assesses the impact on OHCA survival rates and descr...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.009831 |
| _version_ | 1818393308820406272 |
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| author | Spencer May Liying Zhang Dan Foley Erin Brennan Brian O'Neil Ethan Bork Phillip Levy Robert Dunne |
| author_facet | Spencer May Liying Zhang Dan Foley Erin Brennan Brian O'Neil Ethan Bork Phillip Levy Robert Dunne |
| author_sort | Spencer May |
| collection | DOAJ |
| description | Background In 2002, the out‐of‐hospital cardiac arrest (OHCA) survival rate in Detroit was the lowest in the nation. Concerted efforts sought to improve the city's chain of survival with a focus on emergency medical services (EMS). This study assesses the impact on OHCA survival rates and describe factors associated with survival. Methods and Results Data for non‐traumatic OHCA cases in Detroit from 2014 to 2016 were extracted from CARES (Cardiac Arrest Registry to Enhance Survival). Chi‐squared tests, non‐parametric tests, and a multivariable logistic regression analysis were employed to examine the associations between overall survival and its covariates. A total of 2359 non‐traumatic OHCA cases were examined. The overall survival rate increased from 3.7% in 2014 to 5.4% in 2015, and 6.4% in 2016 (P<0.01), reflecting a 73% improvement in survival over the 3‐year period. EMS median on‐scene time decreased over the study period, while the rate at which EMS initiated cardiopulmonary resuscitation and applied an automated external defibrillator (AED) greatly increased (P<0.001). The factors significantly associated with survival were female sex (odds ratio=1.70, P<0.05), a public setting (odds ratio=2.31, P<0.01), an EMS witness (odds ratio=6.18, P<0.01), and the presence of an initial shockable rhythm (odds ratio=1.88, P<0.05). Conclusions From 2014 to 2016, the overall survival rate for OHCA patients in Detroit, MI significantly improved. Our results suggest that an improved chain of survival may explain this progress. This study is an example of how OHCA data analysis and EMS improvement can improve end OHCA outcomes in a resource‐limited urban setting. |
| first_indexed | 2024-12-14T05:43:15Z |
| format | Article |
| id | doaj.art-1ad850c358ce404d853b5767e8c754ec |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-14T05:43:15Z |
| publishDate | 2018-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-1ad850c358ce404d853b5767e8c754ec2022-12-21T23:14:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-08-0171610.1161/JAHA.118.009831Improvement in Non‐Traumatic, Out‐Of‐Hospital Cardiac Arrest Survival in Detroit From 2014 to 2016Spencer May0Liying Zhang1Dan Foley2Erin Brennan3Brian O'Neil4Ethan Bork5Phillip Levy6Robert Dunne7Department of Emergency Medicine Wayne State University School of Medicine Detroit MIDepartment of Family Medicine and Public Health Sciences Wayne State University School of Medicine Detroit MIDepartment of Emergency Medicine Wayne State University School of Medicine Detroit MIDepartment of Emergency Medicine Wayne State University School of Medicine Detroit MIDepartment of Emergency Medicine Wayne State University School of Medicine Detroit MIDepartment of Emergency Medicine Wayne State University School of Medicine Detroit MIDepartment of Emergency Medicine Wayne State University School of Medicine Detroit MIDepartment of Emergency Medicine Wayne State University School of Medicine Detroit MIBackground In 2002, the out‐of‐hospital cardiac arrest (OHCA) survival rate in Detroit was the lowest in the nation. Concerted efforts sought to improve the city's chain of survival with a focus on emergency medical services (EMS). This study assesses the impact on OHCA survival rates and describe factors associated with survival. Methods and Results Data for non‐traumatic OHCA cases in Detroit from 2014 to 2016 were extracted from CARES (Cardiac Arrest Registry to Enhance Survival). Chi‐squared tests, non‐parametric tests, and a multivariable logistic regression analysis were employed to examine the associations between overall survival and its covariates. A total of 2359 non‐traumatic OHCA cases were examined. The overall survival rate increased from 3.7% in 2014 to 5.4% in 2015, and 6.4% in 2016 (P<0.01), reflecting a 73% improvement in survival over the 3‐year period. EMS median on‐scene time decreased over the study period, while the rate at which EMS initiated cardiopulmonary resuscitation and applied an automated external defibrillator (AED) greatly increased (P<0.001). The factors significantly associated with survival were female sex (odds ratio=1.70, P<0.05), a public setting (odds ratio=2.31, P<0.01), an EMS witness (odds ratio=6.18, P<0.01), and the presence of an initial shockable rhythm (odds ratio=1.88, P<0.05). Conclusions From 2014 to 2016, the overall survival rate for OHCA patients in Detroit, MI significantly improved. Our results suggest that an improved chain of survival may explain this progress. This study is an example of how OHCA data analysis and EMS improvement can improve end OHCA outcomes in a resource‐limited urban setting.https://www.ahajournals.org/doi/10.1161/JAHA.118.009831African American, Black, resource‐limitedcardiac arrestemergency medical servicesout‐of‐hospital cardiac arrestsudden cardiac arrestsurveillance |
| spellingShingle | Spencer May Liying Zhang Dan Foley Erin Brennan Brian O'Neil Ethan Bork Phillip Levy Robert Dunne Improvement in Non‐Traumatic, Out‐Of‐Hospital Cardiac Arrest Survival in Detroit From 2014 to 2016 Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease African American, Black, resource‐limited cardiac arrest emergency medical services out‐of‐hospital cardiac arrest sudden cardiac arrest surveillance |
| title | Improvement in Non‐Traumatic, Out‐Of‐Hospital Cardiac Arrest Survival in Detroit From 2014 to 2016 |
| title_full | Improvement in Non‐Traumatic, Out‐Of‐Hospital Cardiac Arrest Survival in Detroit From 2014 to 2016 |
| title_fullStr | Improvement in Non‐Traumatic, Out‐Of‐Hospital Cardiac Arrest Survival in Detroit From 2014 to 2016 |
| title_full_unstemmed | Improvement in Non‐Traumatic, Out‐Of‐Hospital Cardiac Arrest Survival in Detroit From 2014 to 2016 |
| title_short | Improvement in Non‐Traumatic, Out‐Of‐Hospital Cardiac Arrest Survival in Detroit From 2014 to 2016 |
| title_sort | improvement in non traumatic out of hospital cardiac arrest survival in detroit from 2014 to 2016 |
| topic | African American, Black, resource‐limited cardiac arrest emergency medical services out‐of‐hospital cardiac arrest sudden cardiac arrest surveillance |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.009831 |
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