338: COVID-19 VERSUS NON-COVID-19 IN-HOSPITAL CARDIAC ARREST SURVIVAL AT A LARGE US HEALTHCARE SYSTEM

Abstract Background Patients who suffer a sudden out-of-hospital cardiac arrest (OHCA) may be preceded by warning symptoms and healthcare system contact. Though, is currently difficult early identification of sudden cardiac arrest patients. Purpose We aimed to examine contacts with the healthcare system up to two weeks and one year before OHCA. Methods OHCA patients were identified from the Danish Cardiac Arrest Registry (2001–2014). The pattern of healthcare contacts (with either general practitioner (GP) or hospital) within the year prior to OHCA of OHCA patients was compared with that of 9 sex- and age-matched controls from the background general population. Additionally, we evaluated characteristics of OHCA patients according to the type of healthcare contact (GP/hospital/both/no-contact) and the including characteristics of contacts, within two weeks prior their OHCA event. Results Out of 28,955 OHCA patients (median age of 72 (62–81) years and with 67% male) of presumed cardiac cause, 16,735 (57.8%) contacted the healthcare system (GP and hospital) within two weeks prior to OHCA. From one year before OHCA, the weekly percentages of contacts to GP were relatively constant (26%) until within 2 weeks prior to OHCA where they markedly increased (54%). In comparison, 14% of the general population contacted the GP during the same period (Figure). The weekly percentages of contacts with hospitals gradually increased in OHCA patients from 3.5% to 6.5% within 6 months, peaking at the second week (6.8%), prior to OHCA. In comparison, only 2% of the general population had a hospital contact in that period (Figure). Within 2 weeks of OHCA, patients contacted GP mainly by telephone (71.6%). Hospital diagnoses were heterogenous, where ischemic heart disease (8%) and heart failure (4.5%) were the most frequent. Conclusions There is an increase in healthcare contacts prior to “sudden” OHCA and overall, 54% of OHCA-patients had contacted GP within 2 weeks before the event. This could have implications for developing future strategies for early identification of patients prior to their cardiac arrest. Figure 1. The weekly percentages of contacts to GP (red) and hospital (blue) within one year before OHCA comparing the OHCA cases to the age- and sex-matched control population (N cases = 28,955; N controls = 260,595). Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020

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Improved Out-of-Hospital Cardiac Arrest Survival After the Sequential Implementation of 2005 AHA Guidelines for Compressions, Ventilations, and Induced Hypothermia: The Wake County Experience

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2010.01.036 ◽

2010 ◽

Vol 56 (4) ◽

pp. 348-357 ◽

Cited By ~ 90

Author(s):

Paul R. Hinchey ◽

J. Brent Myers ◽

Ryan Lewis ◽

Valerie J. De Maio ◽

Eric Reyer ◽

...

Keyword(s):

Cardiac Arrest ◽

Induced Hypothermia ◽

Wake County ◽

Cardiac Arrest Survival ◽

Hospital Cardiac Arrest ◽

Sequential Implementation

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Temporal trends in out-of-hospital cardiac arrest survival outcomes between two metropolitan communities: Seoul-Osaka resuscitation study

BMJ Open ◽

10.1136/bmjopen-2015-007626 ◽

2015 ◽

Vol 5 (6) ◽

pp. e007626-e007626 ◽

Cited By ~ 17

Author(s):

Y. S. Ro ◽

S. D. Shin ◽

T. Kitamura ◽

E. J. Lee ◽

K. Kajino ◽

...

Keyword(s):

Cardiac Arrest ◽

Temporal Trends ◽

Survival Outcomes ◽

Cardiac Arrest Survival ◽

Hospital Cardiac Arrest

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Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes

Resuscitation ◽

10.1016/j.resuscitation.2018.07.015 ◽

2018 ◽

Vol 130 ◽

pp. 159-166 ◽

Cited By ~ 25

Author(s):

Robert M. Sutton ◽

Ron W. Reeder ◽

William Landis ◽

Kathleen L. Meert ◽

Andrew R. Yates ◽

...

Keyword(s):

Cardiac Arrest ◽

Chest Compression ◽

Survival Outcomes ◽

Cardiac Arrest Survival ◽

Hospital Cardiac Arrest

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PaRamEDIc assessment of laCTate in OHCA and survival to hospital (PREDICT protocol)

Journal of Paramedic Practice ◽

10.12968/jpar.2021.13.3.100 ◽

2021 ◽

Vol 13 (3) ◽

pp. 100-104

Author(s):

Karl Charlton ◽

Hayley Moore

Keyword(s):

Cardiac Arrest ◽

Primary Outcome ◽

Spontaneous Circulation ◽

Prognostic Role ◽

Single Centre ◽

Intravenous Access ◽

Secondary Outcomes ◽

Cardiac Arrest Survival ◽

Hospital Cardiac Arrest

Background: Studies suggest that blood lactate differs between survivors and non-survivors of out-of-hospital cardiac arrest who are transported to hospital. The prognostic role of lactate taken during out-of-hospital cardiac arrest remains unexplored. Aims: To measure the association between lactate taken during out-of-hospital cardiac arrest, survival to hospital and 30-day mortality. Methods: This is a feasibility, single-centre, prospective cohort study. Eligible for inclusion are patients aged ≥18 years suffering out-of-hospital cardiac arrest, receiving cardiopulmonary resuscitation, in the catchment of Newcastle or Gateshead hospitals, who are attended to by a study-trained specialist paramedic. Exclusions are known/apparent pregnancy, blunt or penetrating injury as primary cause of out-of-hospital cardiac arrest and an absence of intravenous access. Between February 2020 and March 2021, 100 participants will be enrolled. Primary outcome is survival to hospital; secondary outcomes are return of spontaneous circulation at any time and 30-day mortality.

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Abstract 249: The Effect of Response Time on Out-Of-Hospital Cardiac Arrest Survival Varies by Patient Subpopulation

Circulation ◽

10.1161/circ.138.suppl_2.249 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Clara Stoesser ◽

Justin Boutilier ◽

Christopher L Sun ◽

Katie N Dainty ◽

Steve Lin ◽

...

Keyword(s):

Cardiac Arrest ◽

Regression Analysis ◽

Response Time ◽

Time Interval ◽

Probability Of Survival ◽

Subgroup Analyses ◽

Impact On Survival ◽

The Impact ◽

Cardiac Arrest Survival ◽

Hospital Cardiac Arrest

Itroduction: Previous research has quantified the impact of EMS response time on the probability of survival from OHCA, but the impact on different subpopulations is currently unknown. Aim: To investigate how response time affects OHCA survival for different patient subpopulations. Methods: We conducted a logistic regression analysis on non-EMS witnessed OHCAs of presumed cardiac etiology from the Toronto Regional RescuNet between January 1, 2007 and December 31, 2016. We predicted survival using age, sex, public location, presenting rhythm, bystander witnessed, bystander resuscitation, and response time, defined as the time interval from 911 call to EMS arrival at the patient. We conducted subgroup analyses to quantify the effect of response time on survival for eight different subpopulations: public, private, bystander resuscitation, no bystander resuscitation, patients ≥65, patients <65, witnessed, and unwitnessed OHCA. We also quantified the effect of response time on survival for pairwise intersections of the subpopulations. We compared our results to Valenzuela et al. (1997), which suggests survival odds decrease by 10% for each minute delay in response time. Results: We identified 22,988 OHCAs. Overall, a one-minute delay in EMS response time was associated with a 13.2% reduction in the odds of survival. The reduction varied by subpopulation, ranging from a 7.2% reduction in survival odds for unwitnessed arrests to a 16.4% reduction in survival odds for arrests with bystander resuscitation. Response time had the largest impact on survival for the subpopulation of OHCAs that were both witnessed and received bystander resuscitation (17.4% reduction in survival odds). Conclusion: The effect of a one-minute delay in EMS response on the odds of survival from OHCA can be as low as a 7.2% reduction and as high as a 17.4% reduction. This variability contrasts with the currently accepted 10% rule that is assumed across the entire population.

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