Abstract 230: Epidemiology and Outcomes of Emergency Medical Services-Assessed Out-of-Hospital Cardiac Arrest in Korea: A Nationwide Observational Study from 2006 to 2010
The goal of this study is to better understand the epidemiologic features and the patient-community-emergency medical service (EMS)-hospital factors affecting outcomes of out-of-hospital cardiac arrest (OHCA).
Methods and Results
This study was performed in an EMS system with a single-tiered basic-to-intermediate service level and approximately 900 destination hospitals for eligible OHCA cases. A nationwide OHCA database including demographic, Utstein, EMS, and hospital factors and outcomes was constructed using EMS run sheets of eligible cases transported by 119 EMS ambulances and followed by medical record review for 2006 to 2010. Cases with unknown outcome were excluded. The primary end points were survival to discharge. The epidemiologic characteristics of OHCA were described and adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated for main outcome, adjusting for potential predictors.
There were 97,291 EMS-assessed OHCAs excluding 14,798 cases because the medical records were not available (N=10,626) and the survival outcomes were unknown (N=4,172). Of these, 73,826 (75.9%) OHCAs were resuscitation attempted by EMS. The survival to discharge was 3.0% for EMS-assessed (3.3% for cardiac origin vs. 2.3% for non-cardiac origin), 3.6% for EMS-treated (4.0% for cardiac vs. 2.7% for non-cardiac), and 20.9% for cardiac origin with shockable rhythm. The drowning, intoxication, and asphyxia induced OHCAs had statistically better survival rates than cardiac origin. The odds for survival to discharge are significantly lower for elderly, asystole as primary ECG, OHCA with cardiac origin occurred in winter or 6PM to midnight, un-witnessed, no bystander cardiopulmonary resuscitation, OHCA with longer EMS response, and being transported to lower level of ED.
In this nationwide cohort study from 2006 to 2010, the standardized incidence rate increased 46.3 in 2006 to 52.0 per 100,000 person-years for EMS-assessed OHCA and overall survival rate was 3.0%. Potential factors for poor outcome were systemically identified in individual, community, EMS, and hospital chain.
- © 2012 by American Heart Association, Inc.