Characteristics, prognostic factors, and chronological trends of out-of-hospital cardiac arrests with shockable rhythms in Taiwan – A 7-year observational study
Background: The study aimed to explore the characteristics, predictors, and chronological trends of outcomes for adult out-of-hospital cardiac arrests (OHCAs) with shockable rhythms. Methods: A 7-year, community-wide observational study using an Utstein-style registry was conducted. Patients who wer...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664622000444 |
| _version_ | 1818049459342278656 |
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| author | Chien-Yu Chi Yen-Pin Chen Chih-Wei Yang Chien-Hua Huang Yao-Chang Wang Kah-Meng Chong Hui-Chih Wang Wan-Ching Lien Mei-Fen Yang Matthew Huei-Ming Ma Chien-Hua Huang Zheng-Cheng Chen Patrick Chow-In Ko |
| author_facet | Chien-Yu Chi Yen-Pin Chen Chih-Wei Yang Chien-Hua Huang Yao-Chang Wang Kah-Meng Chong Hui-Chih Wang Wan-Ching Lien Mei-Fen Yang Matthew Huei-Ming Ma Chien-Hua Huang Zheng-Cheng Chen Patrick Chow-In Ko |
| author_sort | Chien-Yu Chi |
| collection | DOAJ |
| description | Background: The study aimed to explore the characteristics, predictors, and chronological trends of outcomes for adult out-of-hospital cardiac arrests (OHCAs) with shockable rhythms. Methods: A 7-year, community-wide observational study using an Utstein-style registry was conducted. Patients who were not transported, those who experienced trauma and those who lacked electronic electrocardiography data were excluded; those with initial shockable rhythms of ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) were included. Outcomes were survival of discharge (SOD) and favorable neurological status (CPC 1–2). The outcome predictors, chronological trends, and their relationship with system interventions were analyzed. Results: Of the 1544 shockable OHCAs (incidence 12.6%) included, 97.6% had VF and 2.4% had pVT. VF showed better outcomes than pVT. Predictors for both outcomes (SOD; CPC 1–2) were chronological change (adjusted odds ratio [aOR]: 1.133; 1.176), younger age (aOR: 0.973; 0.967), shorter response time (aOR: 0.998; 0.999), shorter scene time (aOR: 0.999; 0.999), witnessed collapse (aOR: 1.668; 1.670), and bystander cardiopulmonary resuscitation (BCPR) (aOR: 1.448; 1.576). Predictors for only SOD were public location (aOR: 1.450) and successful prehospital defibrillation (aOR: 3.374). The use of the supraglottic airway was associated with adverse outcomes. Chronologically with system interventions, BCPR rate, the proportion of shockable OHCA, and improved neurological outcomes increased over time. Conclusion: The incidence of shockable OHCA remained low in Asian community. VF showed better outcomes than pVT. Over time, the incidence of shockable rhythm, BCPR rate and patient outcomes did improve with health system interventions. The number of prehospital defibrillations did not predict outcomes. |
| first_indexed | 2024-12-10T10:37:55Z |
| format | Article |
| id | doaj.art-eae9bdb14f0d40f6b6414524a75c6359 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-10T10:37:55Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-eae9bdb14f0d40f6b6414524a75c63592022-12-22T01:52:23ZengElsevierJournal of the Formosan Medical Association0929-66462022-10-011211019721980Characteristics, prognostic factors, and chronological trends of out-of-hospital cardiac arrests with shockable rhythms in Taiwan – A 7-year observational studyChien-Yu Chi0Yen-Pin Chen1Chih-Wei Yang2Chien-Hua Huang3Yao-Chang Wang4Kah-Meng Chong5Hui-Chih Wang6Wan-Ching Lien7Mei-Fen Yang8Matthew Huei-Ming Ma9Chien-Hua Huang10Zheng-Cheng Chen11Patrick Chow-In Ko12Department of Emergency Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanTaipei City Fire Department, Taipei, TaiwanTaipei City Fire Department, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Health, Taipei City Government, Taipei, TaiwanDepartment of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan; Corresponding author. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan No. 7, Chung-Shan S. Rd, Taipei, Taiwan. Fax: +886 2 23223150.Background: The study aimed to explore the characteristics, predictors, and chronological trends of outcomes for adult out-of-hospital cardiac arrests (OHCAs) with shockable rhythms. Methods: A 7-year, community-wide observational study using an Utstein-style registry was conducted. Patients who were not transported, those who experienced trauma and those who lacked electronic electrocardiography data were excluded; those with initial shockable rhythms of ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) were included. Outcomes were survival of discharge (SOD) and favorable neurological status (CPC 1–2). The outcome predictors, chronological trends, and their relationship with system interventions were analyzed. Results: Of the 1544 shockable OHCAs (incidence 12.6%) included, 97.6% had VF and 2.4% had pVT. VF showed better outcomes than pVT. Predictors for both outcomes (SOD; CPC 1–2) were chronological change (adjusted odds ratio [aOR]: 1.133; 1.176), younger age (aOR: 0.973; 0.967), shorter response time (aOR: 0.998; 0.999), shorter scene time (aOR: 0.999; 0.999), witnessed collapse (aOR: 1.668; 1.670), and bystander cardiopulmonary resuscitation (BCPR) (aOR: 1.448; 1.576). Predictors for only SOD were public location (aOR: 1.450) and successful prehospital defibrillation (aOR: 3.374). The use of the supraglottic airway was associated with adverse outcomes. Chronologically with system interventions, BCPR rate, the proportion of shockable OHCA, and improved neurological outcomes increased over time. Conclusion: The incidence of shockable OHCA remained low in Asian community. VF showed better outcomes than pVT. Over time, the incidence of shockable rhythm, BCPR rate and patient outcomes did improve with health system interventions. The number of prehospital defibrillations did not predict outcomes.http://www.sciencedirect.com/science/article/pii/S0929664622000444Out-of-hospital cardiac arrestVentricular fibrillationVentricular tachycardiaOutcomePrognostic predictor |
| spellingShingle | Chien-Yu Chi Yen-Pin Chen Chih-Wei Yang Chien-Hua Huang Yao-Chang Wang Kah-Meng Chong Hui-Chih Wang Wan-Ching Lien Mei-Fen Yang Matthew Huei-Ming Ma Chien-Hua Huang Zheng-Cheng Chen Patrick Chow-In Ko Characteristics, prognostic factors, and chronological trends of out-of-hospital cardiac arrests with shockable rhythms in Taiwan – A 7-year observational study Journal of the Formosan Medical Association Out-of-hospital cardiac arrest Ventricular fibrillation Ventricular tachycardia Outcome Prognostic predictor |
| title | Characteristics, prognostic factors, and chronological trends of out-of-hospital cardiac arrests with shockable rhythms in Taiwan – A 7-year observational study |
| title_full | Characteristics, prognostic factors, and chronological trends of out-of-hospital cardiac arrests with shockable rhythms in Taiwan – A 7-year observational study |
| title_fullStr | Characteristics, prognostic factors, and chronological trends of out-of-hospital cardiac arrests with shockable rhythms in Taiwan – A 7-year observational study |
| title_full_unstemmed | Characteristics, prognostic factors, and chronological trends of out-of-hospital cardiac arrests with shockable rhythms in Taiwan – A 7-year observational study |
| title_short | Characteristics, prognostic factors, and chronological trends of out-of-hospital cardiac arrests with shockable rhythms in Taiwan – A 7-year observational study |
| title_sort | characteristics prognostic factors and chronological trends of out of hospital cardiac arrests with shockable rhythms in taiwan a 7 year observational study |
| topic | Out-of-hospital cardiac arrest Ventricular fibrillation Ventricular tachycardia Outcome Prognostic predictor |
| url | http://www.sciencedirect.com/science/article/pii/S0929664622000444 |
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