Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study
Abstract Background Prehospital factors play a vital role in out-of-hospital cardiac arrest (OHCA) survivability, and they vary between countries and regions. We investigated the prehospital factors associated with OHCA outcomes in a single metropolitan city in the Republic of Korea. Methods This st...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-023-00899-3 |
| _version_ | 1797453661996056576 |
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| author | Jae Yun Ahn Hyun Wook Ryoo Sungbae Moon Haewon Jung Jungbae Park Won Kee Lee Jong-yeon Kim Dong Eun Lee Jung Ho Kim Sang-Hun Lee |
| author_facet | Jae Yun Ahn Hyun Wook Ryoo Sungbae Moon Haewon Jung Jungbae Park Won Kee Lee Jong-yeon Kim Dong Eun Lee Jung Ho Kim Sang-Hun Lee |
| author_sort | Jae Yun Ahn |
| collection | DOAJ |
| description | Abstract Background Prehospital factors play a vital role in out-of-hospital cardiac arrest (OHCA) survivability, and they vary between countries and regions. We investigated the prehospital factors associated with OHCA outcomes in a single metropolitan city in the Republic of Korea. Methods This study included adult medical OHCA patients enrolled prospectively, using data from the citywide OHCA registry for patients registered between 2018 and 2021. The primary outcome was survival to hospital discharge. Multivariable logistic regression analysis was conducted to determine the factors associated with the study population’s clinical outcomes, adjusting for covariates. We performed a sensitivity analysis for clinical outcomes only for patients without prehospital return of spontaneous circulation prior to emergency medical service departure from the scene. Results In multivariable logistic regression analysis, older age (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.95–0.97), endotracheal intubation (adjusted odds ratio [aOR] 0.29; 95% [CIs] 0.17–0.51), supraglottic airway (aOR 0.29; 95% CI 0.17–0.51), prehospital mechanical chest compression device use (OR 0.13; 95% CI 0.08–0.18), and longer scene time interval (OR 0.96; 95% CI 0.93–1.00) were negatively associated with survival. Shockable rhythm (OR 24.54; 95% CI 12.99–42.00), pulseless electrical activity (OR 3.11; 95% CI 1.74–5.67), and witnessed cardiac arrest (OR 1.59; 95% CI 1.07–2.38) were positively associated with survival. In the sensitivity analysis, endotracheal intubation, supraglottic airway, prehospital mechanical chest compression device use, and longer scene time intervals were associated with significantly lower survival to hospital discharge. Conclusions Regional resuscitation protocol should be revised based on the results of this study, and modifiable prehospital factors associated with lower survival of OHCA should be improved. |
| first_indexed | 2024-03-09T15:26:16Z |
| format | Article |
| id | doaj.art-5d753cbf4e0b456799a877d27f368036 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-03-09T15:26:16Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-5d753cbf4e0b456799a877d27f3680362023-11-26T12:32:07ZengBMCBMC Emergency Medicine1471-227X2023-10-012311910.1186/s12873-023-00899-3Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter studyJae Yun Ahn0Hyun Wook Ryoo1Sungbae Moon2Haewon Jung3Jungbae Park4Won Kee Lee5Jong-yeon Kim6Dong Eun Lee7Jung Ho Kim8Sang-Hun Lee9Department of Emergency Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National UniversityDepartment of Emergency Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National UniversityDepartment of Emergency Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National UniversityDepartment of Emergency Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National UniversityDepartment of Emergency Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National UniversityDepartment of Biostatistics, School of Medicine, Medical Research Collaboration Center, Kyungpook National UniversityDepartment of Public Health, Kyungpook National University Hospital, School of Medicine, Kyungpook National UniversityDepartment of Emergency Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National UniversityDepartment of Emergency Medicine, Yeungnam University College of MedicineDepartment of Emergency Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of MedicineAbstract Background Prehospital factors play a vital role in out-of-hospital cardiac arrest (OHCA) survivability, and they vary between countries and regions. We investigated the prehospital factors associated with OHCA outcomes in a single metropolitan city in the Republic of Korea. Methods This study included adult medical OHCA patients enrolled prospectively, using data from the citywide OHCA registry for patients registered between 2018 and 2021. The primary outcome was survival to hospital discharge. Multivariable logistic regression analysis was conducted to determine the factors associated with the study population’s clinical outcomes, adjusting for covariates. We performed a sensitivity analysis for clinical outcomes only for patients without prehospital return of spontaneous circulation prior to emergency medical service departure from the scene. Results In multivariable logistic regression analysis, older age (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.95–0.97), endotracheal intubation (adjusted odds ratio [aOR] 0.29; 95% [CIs] 0.17–0.51), supraglottic airway (aOR 0.29; 95% CI 0.17–0.51), prehospital mechanical chest compression device use (OR 0.13; 95% CI 0.08–0.18), and longer scene time interval (OR 0.96; 95% CI 0.93–1.00) were negatively associated with survival. Shockable rhythm (OR 24.54; 95% CI 12.99–42.00), pulseless electrical activity (OR 3.11; 95% CI 1.74–5.67), and witnessed cardiac arrest (OR 1.59; 95% CI 1.07–2.38) were positively associated with survival. In the sensitivity analysis, endotracheal intubation, supraglottic airway, prehospital mechanical chest compression device use, and longer scene time intervals were associated with significantly lower survival to hospital discharge. Conclusions Regional resuscitation protocol should be revised based on the results of this study, and modifiable prehospital factors associated with lower survival of OHCA should be improved.https://doi.org/10.1186/s12873-023-00899-3Out-of-hospital cardiac arrest: emergency medical servicesSurvivalAdvanced cardiac life support |
| spellingShingle | Jae Yun Ahn Hyun Wook Ryoo Sungbae Moon Haewon Jung Jungbae Park Won Kee Lee Jong-yeon Kim Dong Eun Lee Jung Ho Kim Sang-Hun Lee Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study BMC Emergency Medicine Out-of-hospital cardiac arrest: emergency medical services Survival Advanced cardiac life support |
| title | Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study |
| title_full | Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study |
| title_fullStr | Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study |
| title_full_unstemmed | Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study |
| title_short | Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study |
| title_sort | prehospital factors associated with out of hospital cardiac arrest outcomes in a metropolitan city a 4 year multicenter study |
| topic | Out-of-hospital cardiac arrest: emergency medical services Survival Advanced cardiac life support |
| url | https://doi.org/10.1186/s12873-023-00899-3 |
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