Introduction:
The majority of research has examined out-of-hospital cardiac arrest (OHCA) patients admitted to intensive care units (ICU). Little is known about patients who are admitted to non-ICU wards. Our study aims to describe short and long term outcomes in OHCA patients admitted directly to medical wards from the emergency department.
Methods:
Data were obtained from the Victorian Ambulance Cardiac Arrest Registry and 12 hospitals for adult, non-traumatic OHCA cases transported to ED between 2014 and 2016.
Results:
Of 1578 OHCAs, 213 (13.5%) were admitted to medical or cardiac wards -only four were admitted for palliation. The majority were witnessed (38% bystander, 58% paramedic), received bystander CPR (91%, n=81/89), median downtime was 4 minutes (IQR 2-12), 179 (84%) were in a shockable rhythm, and 15 received public access defibrillation. Most had ROSC on arrival at ED (99%) and were conscious in ED (91%). Re-arrest inhospital occurred in 16 cases, the majority had a cardiac aetiology (85%) and underwent angiography (75%, 112/160 proceeded to PCI). The majority were discharged alive (n=194, 91%) and most survivors were discharged home (n=176/194, 84%) with good neurological outcomes (CPC 0-2 =94%, CPC 3= 4%). Survivors from the wards made up 30% of the overall OHCA survivors. Of survivors, 175 were alive at 12 months and 159 completed follow-up. The majority of those working prior were working at 12-months (78/92, 85%), 87% in the same role. The mean EuroQol index score for respondents was 0.77 (SD, 0.15). The mean 12-item short form Mental Component Summary score for patients was 55.0 (SD, 8.1), whereas the mean Physical Component Summary score was 49.1 (SD, 9.1).
Conclusion:
In our region OHCA patients admitted to wards have favourable arrest characteristics, and have good short- and long-term outcomes which are similar to regular acute coronary syndrome patients.
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