Abstract 112: Out-of-Hospital Cardiac Arrest: Differences in the Quality of Care Provided by Emergency Medical Services with Advanced Versus Basic Life Support Capabilities---a Nationwide Study
Background: Early and effective prehospital cardiopulmonary resuscitation (CPR) combined with revascularization and induced hypothermia in selected cases is a prerequisite for optimal outcome in out-of-hospital cardiac arrest (OHCA).
Objective: To examine the quality of prehospital CPR and in-hospital treatment of OHCA stratified according to the attending EMS (Emergency Medical Service) unit’s capabilities for Advanced (ALS) or Basic Life Support (BLS).
Design: Follow-up study.
Setting: Nationwide (Denmark). Study period: January 1st to December 31st 2009.
Patients: Non-traumatic OHCA patients over the age of 18.
Measurements: Transthoracic impedance measurements were utilized to assess quality of CPR. No Flow Fraction (NFF) (the fraction of time during resuscitation where the patient is without circulation, spontaneous or artificial); Return of Spontaneous Circulation (ROSC); Cerebral Performance Category (CPC) at hospital discharge and 30-day and 1 year survival.
Results: 2762 patients were included of whom 77% were treated by ALS-capable units. In patients treated by ALS- and BLS-capable units, respectively, the NFF was 0.44 vs. 0.60 (P<0.001), the ROSC-rate was 27 vs. 19 % (adjusted odds ratio (OR) 2.01; 95 % confidence interval (CI) 1.55-2.62), survival at 30-days and 1-year was 10 vs. 7 % (adjusted OR 1.50; 95 % CI 1.01-2.23) and 8 vs. 5 % (adjusted OR 1.35; 95 % CI 0.90-2.05), CPC-score 1-2 (good) at hospital discharge was seen in 46 vs. 38 % (adjusted OR 1.45; 95 % CI 0.96-2.20).
Conclusions: OHCA patients treated by ALS-capable units had a lower NFF and higher short-term survival compared to patients treated by BLS-capable units.
Author Disclosures: N.V. Krarup: Research Grant; Modest; Laerdal, Danish Heart Foundation. Other Research Support; Modest; Physio Control, Falck a/s. J.F. Lassen: None. P. Clemmensen: None. S. Trautner: None. T.M. Hansen: None. S.P. Johnsen: None. C.J. Terkelsen: None.
- © 2014 by American Heart Association, Inc.