Abstract 180: Seven-Year Survey in Ishikawa Prefecture of Out-of-Hospital Cardiac Arrests Due to Nontraumatic Aortic Aneurysm/Dissection in Patients Who Were Transported by Emergency Medical Technicians to Hospitals: Incidence Possibly Underestimated
Aims: To investigate the signs, symptoms and incidences of non-traumatic aortic aneurysm/dissection (A/D) that caused out-of-hospital cardiac arrests (OHCAs) with reference to the level of transported hospitals.
Materials and Methods: Fire departments in Ishikawa Prefecture prospectively collected the data for OHCA cases that were transported by emergency medical technicians (EMTs) during the period from January 2007 to December 2013. The data included the following: backgrounds, prodromal signs and symptoms of the patients; backgrounds of OHCA and bystanders; backgrounds of transported hospital.
Results: Of 7,048 cases of OHCAs, 376, 318, 43, 42 and 62 cases were due to trauma, hanging, conclusive submersion, poisoning and other exogenous causes, respectively. Of the remaining 6,207 endogenous cases, 343 were diagnosed with aortic A/D; of 187 with aortic dissection, 150 cases were complicated with cardiac tamponade that were presumed to cause sudden cardiac arrest. Patients were characterized by high age (median; 81 y, IQR; 73-87) and high rate of comorbidity (Table 1). Prodromal symptoms were rarely caught: chest pain (10%), back pain (3%), abdominal pain (4%), dyspnea (6%) and vomiting/hematemesis (6%). Sudden collapse followed by cardiac arrest was mostly the initial event. The proportion of aortic A/D in endogenous OHCAs in high-diagnostic capacity hospitals (24-hour autopsy imaging available) was significantly higher than that in other hospitals (Fig.1).
Conclusions: The real incidence of OHCAs due to aortic A/D may be much higher than reported.
Author Disclosures: H. Inaba: None. T. Nishi: None. T. Kamikura: None. Y. Takei: None. A. Yamashita: None. Y. Myojo: None. Y. Kita: None.
- © 2014 by American Heart Association, Inc.