Abstract P140: Epidemiologic Feature of Out-of-Hospital Cardiac Arrest Due to Drowning: A Nationwide Cohort Study
INTRODUCTION The aim of this study is to describe the characteristics and outcome among patients with out-of-hospital cardiac arrest (OHCA) caused by drowning as compared with OHCA caused by a cardiac etiology in Korea.
METHODS Korea has a basic life support (BLS) single tiered emergency medical service (EMS) system, operated by the fire department. All OHCA patients are transported to the hospital regardless of the patients’ status. We included all the OHCA patients who were transported by the EMS between 2006 and 2007. Prehospital variables were collected from ambulance service reports and hospital variables were collected from hospital charts by certified medical record administrators.
RESULTS Total number of OHCA during the study periods was 34,059. Among them, the OHCA due to drowning were 789 (2.3%) and the OHCA of cardiac origin were 18,874 (55.4%). The OHCA due to drowning was younger (43±22 vs. 65±17, p<0.001), less frequently witnessed by bystander (26.2% vs. 43.0%, p=0.005), and more frequently received bystander CPR (3.4% vs. 1.9%, p=0.005). The OHCA by drowning less frequently received prehospital or hospital CPR(38.7% vs. 43.9%, p<0.001), less frequently was found in a shockable rhythm (1.7% vs. 4.3%, p<0.001), and showed similar return of simultaneous circulation (ROSC) rate (27.3% vs. 30.3%, NS) as compared with the OHCA of cardiac origin. Among ROSC patients, there was no significant difference in survival admission rate (9.8% vs. 11.2%, NS), and survival discharge rate (2.2% vs. 2.5%, NS). There was no difference in favorable neurologic outcome (CPC 1 or 2) (33.3% 29.0%, NS) between OHCA due to drowning and OHCA of cardiac origin. More than half of OHCA due to drowning occurred in summer (55.3%), but OHCA in cardiac origin showed no seasonal variation (p<0.0001). Both BLS (9 minutes, 5–15 vs. 5 minutes, 6 –9) (median, IQR) and advanced life support (ALS) (37 minutes, 23–58 vs. 20 minutes, 15–27) (median, IQR) significantly delayed in OHCA due to drowning as compared with OHCA of cardiac origin.
CONCLUSION Among OHCA 2.3% were caused by drowning. They had different characteristics compared with OHCA of cardiac origin. But outcomes including ROSC rate, survival admission, and survival discharge were similar in both groups.