Abstract 14037: Improving Trend in Survival From Ventricular Fibrillation in Out-of-Hospital Cardiac Arrest in Rochester Minnesota
Introduction: Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death in the US and a major public health problem. Although it is well known that ventricular fibrillation (VF) has the most favorable outcome among all rhythms in OHCA, there is significant regional variation in survival from VF OHCA. It is crucial to measure the rate of survival from VF OHCA to identify possible need for improvement in the quality of VF OHCA management.
Hypothesis: We assessed the hypothesis that neurologically intact survival from VF OHCA in Rochester, MN has been improving over time.
Methods: We conducted a prospective observational study of VF OHCA patients in Rochester MN from 1985 to 2015. We measured the rate of neurologically intact survival (CPC 1 or 2 at hospital discharge) from VF OHCA. Multiple logistic regression analysis was used for 1991-2015 period to adjust for factors (year period, age, witnessed status, and time from paramedics call to defibrillation) potentially associated with survival to hospital discharge.
Results: During 1985-2015, we identified 477 VF OHCA patients, 389 of whom were bystander-witnessed. Unadjusted survival increased from 31.2% in 1985-1990 to 52.8% in the 2009-2015 period in all VF OHCA patients (unadjusted odds ratio [OR]=2.47; 95% confidence interval [CI], 1.43-4.29) and from 35.7% to 63.5% in the bystander-witnessed subgroup (unadjusted OR=3.13; 95% CI, 1.71-5.83) (Figure). Compared to the 1991-1997 period, adjusted survival for all VF OHCA was significantly higher in the 2009-2015 period (adjusted OR=2.71; 95% CI, 1.43-5.25) and in the bystander-witnessed subgroup (adjusted OR=5.07; 95% CI, 2.39-11.90).
Conclusions: We observed a significant increase in survival to hospital discharge over time in all patients with VF OHCA and in the bystander-witnessed subgroup. Continued vigilance and measurement of variables that can impact patient outcomes are essential components in assessing system performance.
Author Disclosures: M. Okubo: None. E.P. Hess: None. E.J. Atkinson: None. R.D. White: None.
- © 2016 by American Heart Association, Inc.