Abstract 253: Out-of-Hospital Cardiac Arrest Without Return of Spontaneous Circulation in the Field: Who Are the Survivors?
Background: Prompt high quality cardiopulmonary resuscitation is vital for survival from out-of-hospital cardiac arrest (OHCA). Return of spontaneous circulation (ROSC) in the field is one of the most important factors contributing to survival and neurological outcomes following OHCA.
Objectives: To describe characteristics of patients with OHCA treated on scene and transported to hospitals in the Dallas-Fort Worth (DFW)Resuscitation Outcomes Consortium (ROC) site, and compare survivors who did and did not have ROSC in the field.
Methods: We included OHCA cases ≥18 years old treated and transported to a hospital within the DFW ROC site between 2006 through 2011.We report mean age, sex, EMS witnessed arrest, bystander/EMS shock, response time, attempted cardiopulmonary resuscitation, presenting initial rhythm, survival to hospital discharge for survivors with and without ROSC in the field, as well as for those who met criteria for termination of resuscitation.
Results: Included in the study are 5493 OHCA cases; 83.3% (4574) were without ROSC in the field, 11.0% (602) were witnessed by EMS, 41.4% (2272) of the cases had complete EKG data, 16.5% (906) had a shockable rhythm (VF/VT), 69.1% (3798) non-shockable rhythm (PEA, Asystole or AED no shock advised) while 14.4% (789) of the cases could not be determined. Of treated cases, 5.4% (297) survived to hospital discharge; of the 94.6% (5196) who died, 85.9% (4464) died in the Emergency Department, while 14.1% (732) died in the hospital. Further analysis of the survivors showed that 70.7% (210) of the survivors had ROSC in the field, and 29.3% (87) did not. Of interest, 11.1% (33) of survivors met termination of resuscitation criteria (no ROSC, not EMS witnessed, and not shocked in the field). (Table)
Conclusion: In the DFW ROC site, 11.1% of survivors without ROSC in the field met termination of resuscitation criteria. Our data suggest that all treated OHCA patients in the DFW region should be transported to the hospital.
Author Disclosures: Y. Xiong: Employment; Significant; University of Texas Southwestern Med Center. N. Okoro: Employment; Significant; University of Texas Southwestern Med Center. D. Mitchell: None. M. Dwyer: None. A. Leatham: None. G. Salazar: Employment; Significant; University of Texas Southwestern Med Center. A.H. Idris: Employment; Significant; University of Texas Southwestern Med Center. Research Grant; Significant; NIH/NHLBI.
This research has received full or partial funding support from the American Heart Association.
- © 2014 by American Heart Association, Inc.