Abstract 251: Early Defibrillation Influences Long-Term Survival After Out of Hospital Cardiac Arrest
Introduction: Clinical data pertaining to long-term survival after out of hospital cardiac arrest (OHCA) and successful cardio-pulmonary resuscitation (CPR) are sparse. Here we report 1968 cases of OHCA spanning the years 1989 to 1993 with the corresponding follow up ending in 2008.
Methods: The CPR protocol for EMT's followed current guidelines at that time and consisted of cardio compression, mask ventilation and early defibrillation accordingly. Advanced life support (ALS) actions were initiated by an emergency physician, usually arriving later than the EMT in a two tier emergency service. All pre-hospital variables where collected from the protocol of the emergency physician. Hospital data were collected and long term survival was regularly inquired from resident's registration offices.
Results: In 420 out of 1968 cases the ALS team stopped all resuscitation attempts by the EMT`s and declared the patient dead. In 937 cases (47, 6%) resuscitation attempts where not successful, 598 (30, 4%) patients where successfully resuscitated and admitted to a hospital. Seven days after hospital admission 45, 7% out of the 598 admitted patients had died and 82, 4 % at the end of the observation period (>10 years). A total of 84 patients were lost to follow up over the time course. Important predictors for survival were ventricular fibrillation upon arrival of the EMT`s, age ≤ 75 years, witnessed collapse and bystander CPR. A subset of 82 Patients had been successfully resuscitated; however, the EMT team was not equipped with AED. Comparing patients successfully resuscitated with AED to the patients successfully resuscitated without AED, there was little difference in short term survival after 7 days (49,8 % versus 48,8%), but a trend towards better long-term survival for patients resuscitated with AED (4,5% vs. 1,2%) at the end of the follow up period.
Conclusions: Early defibrillation is associated with better long-term survival. Differences to other studies might be due to higher age of our study population.
- © 2010 by American Heart Association, Inc.