Outcomes for out-of-hospital cardiac arrests across 7 countries in Asia: The Pan Asian Resuscitation Outcomes Study (PAROS) |
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| Affiliation: | 1. Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore;2. Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore;3. Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea;4. Singapore Clinical Research Institute Pte Ltd, Singapore, Singapore;5. Department of EMS System, Graduate School, Kokushikan University, Tokyo, Japan;6. Department of Acute Medicine, Kindai University Faculty of Medicine, Osaka, Japan;7. Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan;8. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan;9. Emergency Medicine Department, National University Hospital, Singapore, Singapore;10. Department of Emergency Medicine, Rajavithi Hospital, Bangkok, Thailand;11. Department of Health & Medical Services, ED-Trauma Centre, Rashid Hospital, Dubai, United Arab Emirates;12. Department of Emergency Medicine, Hospital Sungai Buloh, Sungai Buloh, Selangor, Malaysia;13. Medical Department, Singapore Civil Defence Force, Singapore, Singapore;14. Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore;15. Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan, ROC;1. Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;2. Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;3. Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;1. European Resuscitation Council (ERC), Niel, Belgium;2. Consultant in Anaesthesia and Intensive Care, Ospedale Maggiore, Bologna, Italy;1. European Resuscitation Council (ERC), Niel, Belgium;2. Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany;1. European Resuscitation Council (ERC), Niel, Belgium;2. Institute of Anesthesia and Intensive Care, Department of Cardiovascular Sciences, Catholic University of the Sacred Heart, Rome, Italy;1. European Resuscitation Council (ERC), Niel, Belgium;2. IRCCS-Istituto di ricerche farmacologiche “Mario Negri”—IRCCS, Milano, Italy;1. European Resuscitation Council (ERC), Niel, Belgium;2. Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany;1. University of Washington, Harborview Center for Prehospital Emergency Care, Department of Medicine, University of Washington, Seattle, WA, United States;2. University of Washington Clinical Trial Center, Department of Biostatistics, University of Washington, Seattle, WA, United States;3. Kyoto University Health Service, Kyoto, Japan;4. Academic Medical Center, Amsterdam, The Netherlands;5. Helsinki Emergency Medical Service, Helsinki University Central Hospital, Helsinki, Finland;6. St John Ambulance, Perth, WA, Australia;7. University of Western Australia, Perth, WA, Australia;8. Monash University, Melbourne, Vic., Australia;9. Department of Emergency Medicine, Medical University of Vienna, and Municipal Ambulance Service, Vienna, Austria;10. Ambulance Victoria, Vic., Australia;11. Rescu, Li Ka Shing Knowledge Institute, St. Michael''s Hospital and Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ont., Canada;12. Oslo University Hospital, Oslo, Norway;13. Department of Emergency Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, United States;14. Seoul National University, College of Medicine, Seoul, Republic of Korea;15. Department of Anesthesiology and Intensive Medicine, University-Medical Center Hospital, Schleswig-Campus Kiel, Kiel, Germany;p. Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, United States;q. Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan;r. University of Borås, Sahlgrenska University Hospital, Göteborg, Sweden;s. School of Health and Social Sciences, University of Dalarna, Falun, Sweden;t. Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, United States;u. Discipline of General Practice, National University of Ireland, Galway, Ireland and Department of Public Health Medicine, Health Service Executive, Donegal, Ireland;v. Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, United States;w. Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada;x. Department of Emergency Medicine, University of Ottawa, Ottawa, Ont., Canada;y. Department of Emergency Medicine, University of California San Diego, San Diego, CA, United States;1. Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark;2. Unit for Epidemiology and Biostatics, Aalborg University Hospital, Aalborg, Denmark;3. Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark;4. Emergency Medical Services, Copenhagen, the Capital Region of Denmark, Denmark;5. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark;6. Department of Health Science and Technology, Aalborg University, Aalborg, Denmark;7. Department of Cardiology, Aalborg University Hospital, Denmark;1. Paris Descartes University, Faculty of Medicine, Paris, France;2. INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France;3. Schiller Medical SAS, Wissembourg, France;1. Emergency Department, Paris Fire Brigade, Paris, France;2. Schiller Medical SAS, Wissembourg, France;1. Emergency Department, Paris Fire Brigade, Paris, France;2. Paris Descartes University, Faculty of Medicine, Paris, France;3. INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France;4. Department of Cardiology, European Georges Pompidou Hospital, Paris, France |
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| Abstract: | ![]()
BackgroundThe Pan Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network (CRN) was established in collaboration with emergency medical services (EMS) agencies and academic centers in Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and UAE-Dubai and aims to report out-of-hospital cardiac arrests (OHCA) and provide a better understanding of OHCA trends in Asia.Methods and resultsThis is a prospective, international, multi-center cohort study of OHCA across the Asia-Pacific. Each participating country provided between 1.5 and 2.5 years of data from January 2009 to December 2012. All OHCA cases conveyed by EMS or presenting at emergency departments were captured.66,780 OHCA cases were submitted to the PAROS CRN; 41,004 cases were presumed cardiac etiology. The mean age OHCA occurred varied from 49.7 to 71.7 years. The proportion of males ranged from 57.9% to 82.7%. Proportion of unwitnessed arrests ranged from 26.4% to 67.9%. Presenting shockable rhythm rates ranged from 4.1% to 19.8%. Bystander cardiopulmonary resuscitation (CPR) rates varied from 10.5% to 40.9%, however <1.0% of these arrests received bystander defibrillation. For arrests that were with cardiac etiology, witnessed arrest and VF, the survival rate to hospital discharge varied from no reported survivors to 31.2%. Overall survival to hospital discharge varied from 0.5% to 8.5%. Survival with good neurological function ranged from 1.6% to 3%.ConclusionsSurvival to hospital discharge for Asia varies widely and this may be related to patient and system differences. This implies that survival may be improved with interventions such as increasing bystander CPR, public access defibrillation and improving EMS. |
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| Keywords: | Out-of-hospital cardiac arrest Registry Asia-Pacific |
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