Epidemiology, management, and survival rate of out-of-hospital cardiac arrest in Upper Silesia, Poland: an Utstein-style report

Abstract

Introduction: Despite the growing number of studies on the epidemiology of out-of-hospital cardiac arrest (OHCA) in Poland, this issue has not been sufficiently studied. Notably, there has been a lack of uniform Utstein-style data reporting.Aim: To evaluate the epidemiology of OHCA, patient characteristics, the laypeople and emergency medical service (EMS) response to cardiac arrest, and outcomes of OHCA patients, based on a prospective registry encompassing a population of 2.7 million Poles.Material and methods: Consecutive, adult, EMS-treated OHCA cases in 2018 were analyzed. Prehospital data were collected using case report forms by EMS. Information on in-hospital procedures and outcomes was based on data from the public payer of health care services. Multivariable logistic regression analysis was performed to find independent predictors of survival to discharge.Results: A total of 1392 patients were included. Most OHCA occurred at home (74.7%). In 66.8% of OHCA cases, the cardiac arrest was witnessed by bystanders and in another 20.4% by EMS. Laypeople performed cardiopulmonary resuscitation (CPR) in 54.4% of non-EMS-witnessed events, and an automated external defibrillator (AED) was used in 4.6% of patients who received bystander CPR. Finally, 30.7% of all patients were transported to the hospital, and 9.2% survived to hospital discharge. Epinephrine administration, unwitnessed OHCA, longer response time, older age, and initial non-shockable rhythm were independently associated with lower survival to discharge.Conclusions: The prognosis of OHCA patients in Poland is poor. There is still room for improvement in increasing the prevalence of bystander CPR and AED use before EMS arrival.

Does the presence of physician-staffed emergency medical services improve the prognosis in out-of-hospital cardiac arrest? A propensity score matching analysis

“…PCN/CBN/0022/KB/159/21), given the observational nature of the study. The study design of SIL-OHCA and other details on the registry have been presented previously [15][16][17].…”

Prediction of spontaneous circulation recovery in out-of-hospital cardiac arrest cardiopulmonary resuscitation patients using machine learning algorithms.

“…Machine learning is a branch of artificial intelligence that has proven increasingly useful in medicine [1][2][3]. The annual incidence of out-of-hospital cardiac arrests (OHCA) is 34.7-156.0/100000 people in the word [4]. OHCA result in high mortality and poor prognoses.…”

Impact of COVID-19 Pandemic on Patients with ST-Segment-Elevation Myocardial Infarction Complicated by Out-of-Hospital Cardiac Arrest

“…Furthermore, fear of contamination of SARS-CoV-2 might result in more reserved attitudes toward resuscitation practice and a lower rate of successful cardiopulmonary resuscitation (CPR) [7][8][9][10]. The population at risk remained constant; however, recent studies reported a growing incidence of OHCA and a decreased number of STEMI with detrimental outcomes during the pandemic era [7][8][9][10][11]. Limited access to healthcare, more reluctant health-seeking behaviors, and bystander readiness to render life-saving interventions might additionally contribute to the suggested change in the risk of OHCA in STEMI [4][5][6][7][8][9][10][11].…”

“…The population at risk remained constant; however, recent studies reported a growing incidence of OHCA and a decreased number of STEMI with detrimental outcomes during the pandemic era [7][8][9][10][11]. Limited access to healthcare, more reluctant health-seeking behaviors, and bystander readiness to render life-saving interventions might additionally contribute to the suggested change in the risk of OHCA in STEMI [4][5][6][7][8][9][10][11]. Despite the remarkable growth of evidence, there is a lack of data on clinical outcomes in STEMI complicated by OHCA during the COVID-19 pandemic compared to the pre-pandemic era.…”