Trends in care processes and survival following prehospital resuscitation improvement initiatives for out-of-hospital cardiac arrest in British Columbia, 2006–2016

Grunau, Brian; Kawano, Takahisa; Dick, W; Straight, Ronald; Connolly, Helen; Schlamp, Robert; Scheuermeyer, Frank; Fordyce, Christopher B.; Barbic, David; Tallon, John M.; Christenson, Jim

doi:10.1016/j.resuscitation.2018.01.049

Cited by 51 publications

(24 citation statements)

References 38 publications

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“…The rate of survival to hospital discharge among all Beijing EMS-treated OHCA cases was continuously less than 2%, and it remains poor when compared with that of other countries in recent years, including the USA (9.6%), Korea (8.5%) and England (7.9%). [5][6][7][8][9][10] Improving the early links in the cardiac arrest chain of survival, including early recognition and calling the EMS, bystander CPR and the use of public access defibrillation (PAD) can improve outcomes. 18 We found that the distributions of the sex and age of patients with OHCA enrolled in the current study and the ratio of witnessed cardiac arrest were stable during the study years.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of out-of-hospital cardiac arrest in Beijing: a 5-year cross-sectional study

Shao

et al. 2021

BMJ Open

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ObjectiveThe purpose of this study was to assess the trends in outcomes of out-of-hospital cardiac arrest (OHCA) in Beijing over 5 years.DesignCross-sectional study.MethodsAdult patients with OHCA of all aetiologies who were treated by the Beijing emergency medical service (EMS) between January 2013 and December 2017 were analysed. Data were collected using the Utstein Style. Cases were followed up for 1 year. Descriptive statistics were used to characterise the sample and logistic regression was performed.ResultsOverall, 5016 patients with OHCA underwent attempted resuscitation by the EMS in urban areas of Beijing during the study period. Survival to hospital discharge was 1.2% in 2013 and 1.6% in 2017 (adjusted rate ratio=1.0, p for trend=0.60). Survival to admission and neurological outcome at discharge did not significantly improve from 2013 to 2017. Patient characteristics and the aetiology and location of cardiac arrest were consistent, but there was a decrease in the initial shockable rhythm (from 6.5% to 5.6%) over the 5 years. The rate of bystander cardiopulmonary resuscitation (CPR) increased steadily over the years (from 10.4% to 19.4%).ConclusionSurvival after OHCA in urban areas of Beijing did not improve significantly over 5 years, with long-term survival being unchanged, although the rate of bystander CPR increased steadily, which enhanced the outcomes of patients who underwent bystander CPR.

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Section: Discussionmentioning

confidence: 99%

Outcomes of out-of-hospital cardiac arrest in Beijing: a 5-year cross-sectional study

Shao

et al. 2021

BMJ Open

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“…In the last decades, efforts have been made to increase the bystander CPR rate in most countries, especially in developed countries [ 8 ]. Along with the increased bystander CPR rate, OHCA survival rates have been increasing in some developed counties [ 9 – 11 ]. For instance, the bystander CPR rates and OHCA survival rates increased as follows: from 39.4% in 2006–2009 to 48.9% in 2014–2016, and from 10.4 to 14.9% in the same period of time in Canada [ 9 ]; from 28.2% in 2005 to 36.3% in 2012, and from 5.7 to 9.8% in the same period of time in the United States [ 11 ]; from 65.8% in 2006 to 81.2% in 2012, and from 16.2 to 19.7% in the same period of time in the Netherlands [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Evidence has shown that the OHCA survival rate is closely associated with many pre-hospital modifiable factors besides bystander CPR [ 6 , 9 , 14 , 15 ], including initial shockable rhythm, early defibrillation, return of spontaneous circulation (ROSC), and survived event (defined as ROSC sustained until the arrival at the emergency department and transfer of care to medical staff at the receiving hospital) [ 6 , 9 , 14 , 15 ]. Most studies focused on exploring the relationship between prehospital factors and the survival rate after OHCA using multivariate logistic regression analysis [ 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…Data from Canada, the United States, and the Netherlands, where OHCA survival rates have increased over time, have shown that most of the pre-hospital modifiable factors such as bystander CPR, initial shockable rhythm, ROSC, and survived event improved over time [ 9 – 11 ]. In Japan and Australia, although the rates of bystander CPR, initial shockable rhythm, and ROSC were increased, the rates of survival after OHCA and survived event were not improved over time [ 12 , 13 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Trend in survival after out-of-hospital cardiac arrest and its relationship with bystander cardiopulmonary resuscitation: a six-year prospective observational study in Beijing

Chen

Yue

et al. 2021

BMC Cardiovasc Disord

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Background Out-of-hospital cardiac arrest (OHCA), a global health problem with a survival rate ranging from 2 to 22% across different countries, has been a leading cause of premature death for decades. The aim of this study was to evaluate the trends of survival after OHCA over time and its relationship with bystander cardiopulmonary resuscitation (CPR), initial shockable rhythm, return of spontaneous circulation (ROSC), and survived event. Methods In this prospective observational study, data of OHCA patients were collected following the “Utstein style” by the Beijing, China, Emergency Medical Service (EMS) from January 2011 (data from February to June in 2011 was not collected) to October 2016. Patients who had a cardiac arrest and for whom an ambulance was dispatched were included in this study. All cases were followed up to determine hospital discharge or death. The trend of OHCA survival was analyzed using the Chi-square test. The relationship among bystander CPR, initial shockable rhythm, ROSC, survived event, and OHCA survival rate was analyzed using multivariate path analyses with maximum standard likelihood estimation. Results A total of 25,421 cases were transferred by the Beijing EMS; among them, 5042 (19.8%) were OHCA (median age: 78 years, interquartile range: 63–85, 60.1% male), and 484 (9.6%) received bystander CPR. The survival rate was 0.6%, which did not improve from 2012 to 2015 (P = 0.569). Overall, bystander CPR was indirectly associated with an 8.0% (β = 0.080, 95% confidence interval [CI] = 0.064–0.095, P = 0.002) increase in survival rate. The indirect effect of bystander CPR on survival rate through survived event was 6.6% (β = 0.066, 95% CI = 0.051–0.081, P = 0.002), which accounted for 82.5% (0.066 of 0.080) of the total indirect effect. With every 1 increase in survived event, the possibility of survival rate will directly increase by 53.5% (β = 0.535, 95% CI = 0.512–0.554, P = 0.003). Conclusions The survival rate after OHCA was low in Beijing which has not improved between 2012 and 2015. The effect of bystander CPR on survival rate was mainly mediated by survived event. Trial registration Chinese Clinical Trial Registry: ChiCTR-TRC-12002149 (2 May, 2012, retrospectively registered). http://www.chictr.org.cn/showproj.aspx?proj=7400

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“…Among these studies, different interventions for system performance improvement were implemented in different contexts (IHCA versus OHCA); the heterogeneity of the studies precludes any meta-analysis. Thirteen of these studies 92À97, 99,100,102,103,105,106,108 showed an association of significantly higher chance of survival with favorable neurological outcome at discharge with implementation of interventions for system performance improvement. The other 6 studies, 91,98,101,104,107,109 including 1 cluster-randomized trial, 91 showed no significant improvement after interventions were implemented.…”

Section: Consensus On Sciencementioning

confidence: 99%

Education, Implementation, and Teams

Greif¹,

Bhanji²,

Bigham³

et al. 2020

Resuscitation

103

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Trends in care processes and survival following prehospital resuscitation improvement initiatives for out-of-hospital cardiac arrest in British Columbia, 2006–2016

Cited by 51 publications

References 38 publications

Outcomes of out-of-hospital cardiac arrest in Beijing: a 5-year cross-sectional study

Outcomes of out-of-hospital cardiac arrest in Beijing: a 5-year cross-sectional study

Trend in survival after out-of-hospital cardiac arrest and its relationship with bystander cardiopulmonary resuscitation: a six-year prospective observational study in Beijing

Education, Implementation, and Teams

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