The Swietokrzyskie Out-of-Hospital Cardiac Arrest Registry. Preliminary Results.

Abstract:

Introduction

Despite major advances in all the fields of cardiology sudden cardiac arrest (SCA) is still associated with a high rate of unsuccessful cardiopulmonary resuscitation. The purpose of the present study is to describe the interventions in post-cardiac arrest management in Swietokrzyskie Province between 2013 and 2016 taking into account potential changes in the management pattern and their impact on the effectiveness of prehospital care.

Methods

In this study we performed a retrospective evaluation of patients after sudden cardiac arrest (SCA) in Swietokrzyskie Province. We analyzed the factors that potentially influenced the effectiveness of prehospital care; data from the ambulance case records had been collected by paramedics and physicians before referring patients to hospital. A total of 353 537 ambulance rides had been analyzed, including 2959 (0.84%) out-of-hospital cardiac arrest patients` emergency calls.

Results

The rate of out-of-hospital cardiac arrest (OHCA) in Swietokrzyskie Province was similar for four consecutive years ranging from 51.00 to 64.03 cases per 100 000 population, whereas cardiopulmonary resuscitation (CPR) was performed in 34.7 to 45.4 cases per 100 000 people. From 23.7% to 32.4% of patients were found dead on arrival at the scene. Between 40.2% and 43.8% of patients achieved return of spontaneous circulation (ROSC) following cardiopulmonary resuscitation. The number of witnesses increased significantly from 19.1% in 2013 to 39.3% in 2016. Likewise, the number of patients admitted directly to the Intensive Coronary Care Unit increased significantly from 3.2% in 2013 to 7.4% in 2016.

Conclusions

The initial success of CPR attempted by emergency medical service teams in Swietokrzyskie Province between 2013 and 2016 remained unchanged, being in good agreement with data from national and international surveys. The increasing number of witnesses did not affect significantly CPR success. The increasing number of patients admitted directly to a PCI center is a positive tendency which indicates the improved availability of invasive coronary procedures in Swietokrzyskie Province.