Kuo Chan-Wei, See Lai-Chu, Tu Hui-Tzu, Chen Jih-Chang
Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung Medical Foundation, Taiwan.
Biostatistics Consulting Center, Department of Public Health, College of Medicine, Chang Gung University, Taiwan; Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taiwan.
J Emerg Med. 2014 Jun;46(6):782-90. doi: 10.1016/j.jemermed.2013.08.026. Epub 2013 Oct 2.
Most out-of-hospital cardiac arrest (OHCA) studies have been conducted in developed countries or metropolitan areas, and few in developing countries or rural areas.
The aims of this study were to determine the weak links in the chain of survival and to estimate the outcomes of OHCA patients in Taoyuan, a nonmetropolitan area in Taiwan.
A retrospective review and analysis of OHCA data was conducted. The three outcomes were whether a return of spontaneous circulation (ROSC) was achieved, whether the patient survived to admission, or whether the patient survived to hospital discharge.
From April to December 2008, 1048 OHCA patients were resuscitated, and 712 (67.9%) adult cardiac patients were used in this study. Among these 712 patients, 17.8% achieved ROSC (95% confidence interval [CI] 15.2-20.8%), 16.3% survived to admission (95% CI 13.6-19.0%), and 1.4% survived to discharge (95% CI 0.5-2.3%). Factors significantly associated with the three outcomes were witness status, response time to emergency medical services, and whether the patient had a shockable rhythm. Bystander cardiopulmonary resuscitation (CPR) did not add a notable benefit to the outcomes of OHCA.
The survival rate of OHCA patients in nonmetropolitan Taiwan was very low (1.4%). Lower witnessed rate, lower bystander CPR rate, and longer response interval in remote areas are the main causes of inferior survival rate.
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