Abstract 2013: Predictors of Out-of-hospital Cardiac Arrest Survival: Influence of The Utstein Measures.
Background The Utstein elements provide measures for comparing out-of-hospital cardiac arrest (OHCA) care and outcomes within and across communities. Whether these measures sufficiently predict survival and explain variation in outcome is not well studied.
Hypotheses Utstein data elements predict survival to hospital discharge but explain only a portion of survival variation.
Design Prospective, population-based cohort using uniform data definitions.
Setting Ten North American sites participating in the Resuscitation Outcomes Consortium, a prehospital emergency care network.
Population Persons ≥ 20 years with OHCA from 12/1/2005 – 11/30/2006 (n=9582).
Analyses We used logistic regression to assess association between Utstein elements and survival and to determine whether they accounted for site survival differences. We evaluated measures of residual variance to assess what proportion of outcome variation the Utstein elements predicted.
Results Survival was 7.0% overall. Utstein elements were associated with survival (Table⇓). Relationships were similar when restricted to those with ventricular fibrillation. In analyses assessing variance of residuals, Utstein elements collectively accounted for 15% of variation in survival. Site was also associated with survival, ranging from 3.7% to 15.6%. In multivariable analyses, site association was not attenuated by adjusting for Utstein elements.
Conclusion Although Utstein elements predict survival, they account for a modest portion of variation overall and do not explain survival differences across sites. Additional factors should be investigated to understand and potentially improve OHCA outcome.