A b s t r a c tBackground: Out-of-hospital cardiac arrest (OHCA) is the sudden, unexpected loss of heart function, which occurs out of specialist healthcare facilities and inevitably leads to death if uninterrupted by effective cardiopulmonary resuscitation (CPR). Aim:To evaluate the circumstances and basic epidemiological indices of OHCA in the population of adult inhabitants of Bielsko-Biala district within 12 months. Methods:On the basis of standard ambulance dispatch cards of the Emergency Medical Services (EMS) teams, a retrospective analysis was made of 272 OHCA cases covering the period from 01.01.2013 to 31.12.2013. We assessed the basic demographic data of the victims, circumstances of the occurrence of OHCA, information on the potential cause and mechanism of the OHCA, and data related to the actions undertaken by witnesses and EMS teams. Results:The overall OHCA incidence was 170/100,000 (243/100,000 in men; 99/100,000 in women). It increased with subjects' age (p < 0.01). The most frequent place of OHCA was the victim's home (82%). OHCA occurred in the presence of witnesses in 60% of cases. CPR was undertaken by a witness in 56% cases. Median CPR duration undertaken by a witness was 10 (IQR 8-14) min. Median time from notification receipt by the EMS to the team arrival was 9 (7-11) min. On the scene, defibrillation rhythm was recognised in 39% of cases. Sixty-seven patients were declared deceased after the arrival of the EMS teams. In the remaining 205 cases, CPR was undertaken, which was ineffective for 141 persons. Median CPR duration undertaken by the EMS team was 30 (20-40) min. The overall prehospital case fatality ratio was 76.5% (75.3% for men; 79.3% for women).Conclusions: OHCA incidence in the Bielsko-Biala population in 2013 was high, increased with age, and was twice as high for men than women. OHCA occurred most often at home, in the presence of a witness; however, CPR was not always undertaken promptly at the scene. CPR was effective for approximately 30% of the victims. The prehospital mortality was high with no differences between genders.

IntroductionThe prognosis in out-of-hospital sudden cardiac arrest (OHCA) remains unfavorable and depends on a number of demographic and clinical variables, the reversibility of its causes and its mechanisms.AimTo investigate the risk factors of prehospital death in patients with OHCA in Bielsko County.Material and methodsThe study analyzed all dispatch cards of the National Emergency Medical Services (EMS) teams in Bielsko-Biala for the year 2013 (n = 23 400). Only the cards related to sudden cardiac arrest in adults were ultimately included in the study (n = 272; 190 men, 82 women; median age: 71 years).ResultsSixty-seven victims (45 men, 22 women) were pronounced dead upon the arrival of the EMS team, and cardiopulmonary resuscitation (CPR) was not undertaken. In the remaining group of 205 subjects, CPR was commenced but was ineffective in 141 patients (97 male, 44 female). Although univariate analysis indicated 6 predictors of prehospital death, including OHCA without the presence of witnesses (odds ratio (OR) = 4.2), OHCA occurring in a public place (OR = 3.1), no bystander CPR (OR = 9.7), no bystander cardiac massage (OR = 13.1), initial diagnosis of non-shockable cardiac rhythm (OR = 7.0), and the amount of drugs used for CPR (OR = 0.4), logistic regression confirmed that only the lack of bystander cardiac massage (OR = 6.5) and non-shockable rhythm (OR = 4.6) were independent determinants of prehospital death (area under ROC curve = 0.801).ConclusionsNon-shockable rhythm of cardiac arrest and lack of bystander cardiac massage are independent determinants of prehospital death in Bielsko-Biala inhabitants suffering from OHCA.

Introduction. Out-of-hospital cardiac arrest (OHCA) is one of the most severe medical emergencies, with significantly high both pre-and in-hospital mortality rates. The aim of the study was to assess the quality of reporting OHCA data by the Emergency Medical Service teams (EMS) in the Bielsko-Biała county, using standard ambulance dispatch cards.