Association between ambulance response time and neurologic outcome in patients with cardiac arrest

Lee, Dongwook; Moon, Hyung Jun; Heo, Nam Hun; KoCARC,

doi:10.1016/j.ajem.2019.02.021

Cited by 31 publications

(23 citation statements)

References 20 publications

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“…With bystander CPR, the response time could be prolonged to 7.5 minutes. For OHCAs of cardiac origin, response time less than 7.5 minutes was found to increase the odds of survival to discharge and had better neurological outcome [15]. In the present study, when response time was prolonged by 1 minute, we found decreased odds of survival to discharge in both the older (OR = 0.833, 95% CI: 0.742-0.928) and younger groups (OR = 0.860, 95% CI: 0.811-0.909).…”

Section: Discussionmentioning

confidence: 87%

“…Many previous studies have demonstrated that prehospital factors are associated with the outcomes of OHCA, such as location of OHCA [3,13], EMS response time [15,16], attended by EMT-Paramedic [17], and witness of OHCA [18]. Some studies attempted to exam the in uence of bystander CPR on OHCA outcomes, but the results were inconclusive.…”

Section: Discussionmentioning

confidence: 99%

“…OHCAs occurring in different areas might impact the EMS response time, and might re ect different socioeconomic status of the countries [3,10]. Shorter response time, younger age, OHCA occurring during the daytime, urban areas, and socioeconomic status are usually associated with better prognosis [15,16,24,25]. However, people who have OHCAs in public locations tend to be healthier, are able to move freely, and probably have less comorbidity, and thus have better outcomes [26].…”

Section: Discussionmentioning

confidence: 99%

“…EMS response time was de ned as the duration of time from when a call is made to the EMS to the point when the EMT arrive at the scene. Recently, several studies revealed that shorter EMS response time could improve outcome of OHCA [15,16,21,27]. Shorter EMS response time was associated with a higher rate of survival to discharge and of 1 year survival [27].…”

Section: Discussionmentioning

confidence: 99%

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Association Between Modifiable Prehospital Prognostic Factors on Out-Of-Hospital Cardiac Arrest in Different Age Groups

Huang

Lee

et al. 2020

Preprint

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Background The prognosis of out-of-hospital cardiac arrest (OHCA) is very poor. While several prehospital factors are known to be associated with improved survival, the impact of prehospital factors on different age groups is unclear. The objective of the study was to access the impact of prehospital factors and pre-existing comorbidities on OHCA outcomes in different age groupsMethods A retrospective observational analysis was conducted using the emergency medical service (EMS) database from January 2015 to December 2019. We collected information on prehospital factors, underlying diseases, and outcome of OHCAs in different age groups. Kaplan-Meier type survival curves and multivariable logistic regression were used to analyze the association between modifiable pre-hospital factors and outcomes. Results A total of 4188 witnessed adult OHCAs were analyzed. For the younger group (age ≦75 years old), after adjustment for confounding factors, EMS response time (odds ratio [OR]=0.860, 95% confidence interval [CI]: 0.811-0.909, p<0.001), public location (OR=1.843, 95% CI: 1.179-1.761, p<0.001), bystander CPR (OR=1.329, 95% CI: 1.007-1.750, p=0.045), attendance by an EMT-Paramedic (OR=1.666, 95% CI: 1.277-2.168, p<0.001), and prehospital defibrillation by automated external defibrillator (AED)(OR=1.666, 95% CI: 1.277-2.168, p<0.001) were prognostic factors for OHCA. For the older group (age >75 years old), age (OR=0.924, CI: 0.880-0.966, p=0.001), EMS response time (OR=0.833, 95% CI: 0.742-0.928, p=0.001), public location (OR=4.290, 95% CI: 2.450-7.343, p<0.001), and attendance by an EMT-Paramedic (OR=2.702, 95% CI: 1.704-4.279, p<0.001) were independent prognostic factors for OHCA.Conclusions There were variations between younger and older OHCA patients. We found that bystander CPR and prehospital defibrillation by AED were independent prognostic factors for younger OHCA patients but not for the older group.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association Between Modifiable Prehospital Prognostic Factors on Out-Of-Hospital Cardiac Arrest in Different Age Groups

Huang

Lee

et al. 2020

Preprint

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“…However, other studies have drawn attention to the need for a rapid EMS response. Response time ≤ 7.5 min may lead to favorable neurological outcomes in OHCA patients [25]. Goto et al [26] reported that the upper limits of EMS response times associated with improved 1-month neurologically intact survival were 13 min when a witness started CPR and provided defibrillation, and 11 min CPR was initiated without defibrillation.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland: a one-year retrospective study

Czapla

Zielińska

Kubica-Cielińska

et al. 2020

BMC Cardiovasc Disord

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Background: Out-of-hospital cardiac arrest (OHCA) is a common reason for calls for intervention by emergency medical teams (EMTs) in Poland. Regardless of the mechanism, OHCA is a state in which the chance of survival is dependent on rapid action from bystanders and responding health professionals in emergency medical services (EMS). We aimed to identify factors associated with return of spontaneous circulation (ROSC). Methods: The medical records of 2137 EMS responses to OHCA in the city of Wroclaw, Poland between July 2017 and June 2018 were analyzed. Results: The OHCA incidence rate for the year studied was 102 cases per 100,000 inhabitants. EMS were called to 2317 OHCA events of which 1167 (50.4%) did not have resuscitation attempted on EMS arrival. The difference between the number of successful and failed cardiopulmonary resuscitations (CPRs) was statistically significant (p < 0.001). Of 1150 patients in whom resuscitation was attempted, ROSC was achieved in 250 (27.8%). Rate of ROSC was significantly higher when CPR was initiated by bystanders (p < 0.001). Patients presenting with asystole or pulseless electrical activity (PEA) had a higher risk of CPR failure (86%) than those with ventricular fibrillation/ventricular tachycardia (VF/VT). Patients with VF/VT had a higher chance of ROSC (OR 2.68, 1.86-3.85) than those with asystole (p < 0.001). The chance of ROSC was 1.78 times higher when the event occurred in a public place (p < 0.001). Conclusions: The factors associated with ROSC were occurrence in a public place, CPR initiation by witnesses, and presence of a shockable rhythm. Gender, age, and the type of EMT did not influence ROSC. Low bystander CPR rates reinforce the need for further efforts to train the public in CPR.

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Evaluation psychischer Belastungssituationen der Smartphone-basierten Ersthelferalarmierung „Mobile Retter“

Stroop

Eckert²,

Poschkamp

et al. 2020

Notfall Rettungsmed

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Association between ambulance response time and neurologic outcome in patients with cardiac arrest

Cited by 31 publications

References 20 publications

Association Between Modifiable Prehospital Prognostic Factors on Out-Of-Hospital Cardiac Arrest in Different Age Groups

Association Between Modifiable Prehospital Prognostic Factors on Out-Of-Hospital Cardiac Arrest in Different Age Groups

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland: a one-year retrospective study

Evaluation psychischer Belastungssituationen der Smartphone-basierten Ersthelferalarmierung „Mobile Retter“

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