Out-of-hospital cardiac arrest in an oriental metropolitan city |
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| Institution: | 1. Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon;2. Emergency Medical Services and Pre-hospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon;1. Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Taipei, Taiwan;2. Department of Emergency Medicine, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Linkou, Taiwan;3. Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan;1. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83 Stockholm, Sweden;2. Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar;3. Helsinki University and Department of Emergency Medicine and Services, Helsinki University Hospital, Haartmaninkatu 4, 00029 HUS, Finland;4. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia;5. Department of Medicine Solna, 171 00, Karolinska Institutet, Sweden;6. Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA;7. Hamad Medical Corporation Ambulance Service, Medical City, Doha, PO Box 3050, Qatar;8. School of Health and Social Work, Paramedic Division, University of Hertfordshire, Hatfield, AL10 9AB, HERTS, UK;9. Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, PO Box 3050, Qatar;10. Neuroscience Institute, Hamad Medical Corporation, PO Box 3050, Doha, Qatar;11. Cardiology Research, Heart Hospital, Hamad Medical Corporation, Doha, PO Box 3050, Qatar;12. The Alfred Hospital, Emergency and Trauma Centre, School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC 3004, Australia |
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| Abstract: | To investigate the epidemiology of out-of-hospital cardiac arrest in Taipei City, Taiwan, a prospective chart review and follow-up study was conducted by collecting the prehospital cardiac arrest record from 10 designated responsible emergency departments (EDs) from August 1, 1992 through May 31, 1993. Cases with the restoration of spontaneous circulation (ROSC) were followed up until discharged from hospital. The information gathered included age, sex, bystander cardiopulmonary resuscitation, response time (time elapsed from receiving the call to arrival on the scene), advanced cardiac life support (ACLS) time (time elapsed from receiving the call to arrival at the ED), initial cardiac rhythm in the ED, ROSC, survival to discharge from the hospital, underlying disease, past history, personal history, and neurological outcome at discharge. Of 638 out-of-hospital cardiac arrests, 554 (86.7%) were nontraumatic. Response time, ACLS time, ROSC rates, and survival rates were 7.4 minutes, 21.6 minutes, 15.8%, and 1.4%, respectively. In comparing the trauma and nontrauma group, there were significant differences in age, sex, response time, and ACLS time. Between cases of patients who had ROSC and those who died, the data were statistically significant, P = .0143, showing that ACLS time was shorter in the ROSC group (19.5 v 21.9 minutes). In analysis of underlying disease, definite and probable cardiac-origin sudden deaths were found in only 120 patients, which may extend the annual sudden cardiac death rates to be 0.0053%. In conclusion, the low resuscitation and survival rates in this country were because of delayed initiation of both basic life support and ACLS. Out-of-hospital arrests of noncardiac origin had an extremely low survival rate |
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