Abstract 221: Comparison of Characteristics and Outcome of Out-of-Hospital Cardiac Arrest Occuring in the Workplace and Outside the Workplace : 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) occured in the workplace
Methods: A nationwide OHCA database (2008) (the CAVAS project) was developed based on EMS registry, which was constructed from ambulance run sheet and followed by medical record review. The essential elements of the database were based on the Utstein style. Included factors are social and demographic data, call time, hospital arrival time, existence of witness, utilization of automated external defibrillators (AED), providence of Prehospital cardiopulmonary resuscitation (CPR) as well as inhospital CPR. Outcome value as survival to discharge and cerebral performance category (CPC) was also collected. We selected presumed cardiac origin OHCA for the analysis We did univariate and multivariate analysis to compare the characteristics of OHCA occuring in the workplace (OHCA-IW) with OHCA occuring outside of the workplace (OHCA-OW).
Results: Total number of presumed cardiac origin OHCA during the study periods was 13,606. Among them, the OHCA-IW were 444 (3.3%) and the OHCA-OW were 13,162 (96.7%). The OHCA-IW was younger (56.9±12.2 vs. 65.6±17.9, p<0.001), more frequently witnessed by bystander (50.7.2% vs. 45.0%, p=0.0002) and more frequently received bystander CPR (3.2% vs. 1.9%, p=0.108), more frequently had shockable rhythm (14.9 % vs. 4.0%, p<0.0001, more frequently defibrillated by EMS provider (36.3% vs. 18.5%, p<0.0001), more intensive post-resuscitation care in the hospital (3.8% vs 1.8% , p=0.02). As a result, the survival discharge rate was higher in OHCA-IW (7.0% vs. 2.8%, p<0.0001), but the rate of good CPC was not significantly different between OHCA-IW and OHCA-OW (45.2% vs. 34.1%, p=0.215). The multivariate logistic regression model showed lower ratio of female (OR 0.42, 0.30–0.60), longer BLS interval(OR 1.03, 1.0–1.06), lower ratio of PEA (OR 0.35, 0.18–0.66) and lower ratio of asystole (OR 0.4, 0.27–0.59).
Conclusion: OHCA-IW showed better outcome compared with OHCA-OW. It can be explained as the effect of higher rate of witness, bystander CPR, shockable rhythm, and EMS defibrillation.
- © 2010 by American Heart Association, Inc.