Abstract 274: Low Survival Rate From Cardiac Arrests in Care Facilities Among Public Facilities: an Example of Disarrangement of Links in “Chain of Survival”
Introduction: Population aging in Japan has been advancing rapidly (http://esa.un.org/unpp/), which is leading to an increased number of care facilities for aged citizens.
Aims: To compare the outcomes of cardiac arrests in care facilities with those in other public facilities and to indentify the disadvantageous factors related to survival.
Methods: Of 4559 resuscitation-attempted out-of -hospital cardiac arrests (OHCAs) that occurred before arrival of emergency medical technicians (EMT) from April, 2003 to March, 2009 in Ishikawa Prefecture, 556 arrests occurred in care facilities and 866 arrests in other public facilities. We analyzed the data that were prospectively collected.
Results: Patients' age and incidences of CPR before arrival and preexisting disabilities were higher, and majority of resuscitation attempts was made by health care providers in care facilities. Intervals of arrest recognition/collapse to call and call to arrival were longer in care facilities. Interval of call to first CPR is significantly shorter in care facilities, but it is in a negative range in approximately half of OHCAs, indicating that CPR was performed occasionally without making emergency call. Incidence of VF/VT as an initial rhythm and survival rates at 1M and 1Y were significantly lower in care facilities. Multiple logistic regression analysis revealed that care facility is one of independent factors associated with low incidence of VF/VT as an initial rhythm (OR = 1.40–3.58) and low survival rates at 1M (1.15 – 2.37) and 1Y (1.42 – 3.64)
Conclusions: The links of “chain of survival” are occasionally disarranged in care facilities and their manual for emergency call should be revised.
- © 2010 by American Heart Association, Inc.