Cold Weather and Cardiac Arrest in 4 Seasons: Helsinki, Finland, 1997‒2018

Objectives. To test the a priori hypothesis that out-of-hospital cardiac arrest (OHCA) is associated with cold weather during all seasons, not only during the winter. Methods. We applied a case‒crossover design to all cases of nontraumatic OHCA in Helsinki, Finland, over 22 years: 1997 to 2018. We statistically defined cold weather for each case and season, and applied conditional logistic regression with 2 complementary models a priori according to the season of death. Results. There was an association between cold weather and OHCA during all seasons, not only during the winter. Each additional cold day increased the odds of OHCA by 7% (95% confidence interval [CI] = 4%, 10%), with similar strength of association during the autumn (6%; 95% CI = 0%, 12%), winter (6%; 95% CI = 1%, 12%), spring (8%; 95% CI = 2%, 14%), and summer (7%; 95% CI = 0%, 15%). Conclusions. Cold weather, defined according to season, increased the odds of OHCA during all seasons in similar quantity. Public Health Implications. Early warning systems and cold weather plans focus implicitly on the winter season. This may lead to incomplete measures in reducing excess mortality related to cold weather. (Am J Public Health. 2022;112(1):107–115. https://doi.org/10.2105/AJPH.2021.306549 )

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Out of hospital cardiac arrest in Western Sydney - an analysis of outcomes and estimation of future eCPR eligibility

10.21203/rs.3.rs-1083706/v1 ◽

2021 ◽

Author(s):

Pramod Chandru ◽

Tatum Priyambada Mitra ◽

Nitesh Dutt Dhanekula ◽

Mark Dennis ◽

Adam Eslick ◽

...

Keyword(s):

Cardiac Arrest ◽

Life Support ◽

Rescue Therapy ◽

A Priori ◽

Advanced Life Support ◽

Spontaneous Circulation ◽

Eligibility Criteria ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Poor Outcomes ◽

Hospital Cardiac Arrest

Abstract Background Refractory out of hospital cardiac arrest (OHCA) is associated with extremely poor outcomes. However, in selected patients extracorporeal cardiopulmonary resuscitation (eCPR) may be an effective rescue therapy, allowing time treat reversible causes. The primary goal was to estimate the potential future caseload of eCPR at historically 'low-volume' extracorporeal membrane oxygenation (ECMO) centres. Methods A 3-year observational study of OHCA presenting to the Emergency Department (ED of an urban referral centre without historical protocolised use of eCPR. Demographics and standard Utstein outcomes are reported. Further, an a priori analysis of each case for potential eCPR eligibility was conducted. A current eCPR selection criteria (from the 2-CHEER study) was used to determine eligibly. Results In the study window 248 eligible cardiac arrest cases were included in the OHCA registry. 30-day survival was 23.4% (n=58). The mean age of survivors was 55.4 years. 17 (6.8%) cases were deemed true refractory arrests and fulfilled the 2-CHEER eligibility criteria. The majority of these cases presented within “office hours” and no case obtained a return of spontaneous circulation standard advanced life support. Conclusions In this contemporary OHCA registry a significant number of refractory cases were deemed potential eCPR candidates reflecting a need for future interdisciplinary work to support delivery of this therapy.

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Abstract 246: The Relationship Between Favorable Neurological Outcome in Patients With Out-of-Hospital Cardiac Arrest Due to Cardiac Etiology and Regional Disparity of the Number of Physicians

Circulation ◽

10.1161/circ.138.suppl_2.246 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Tsukasa Yagi ◽

Ken Nagao ◽

Shigemasa Tani ◽

Eizo Tachibana ◽

Nobutaka Chiba ◽

...

Keyword(s):

Public Health ◽

Cardiac Arrest ◽

Neurological Outcome ◽

Multivariable Analysis ◽

Public Health Problem ◽

Regional Disparity ◽

Major Public Health Problem ◽

Favorable Neurological Outcome ◽

The Relationship ◽

Hospital Cardiac Arrest

Background: Cardiac arrest is a major public health issue worldwide. In Japan, the regional disparity of the number of physicians per 100000 population is also a major public health problem. However, it is unknown whether there is the relationship between favorable neurological outcome in patients with out-of-hospital cardiac arrest (OHCA) due to cardiac etiology and this regional disparity. The aim of the present study was to clarify this relationship using the data of the All-Japan Utstein Registry, a prospective, nationwide, population-based registry of OHCA. Methods: From the data of the All-Japan Utstein Registry between 2011 and 2015, we included adult patients who had OHCA due to cardiac etiology. 47 prefectures of Japan were divided into quartiles on the basis of the number of physicians in each prefecture, reported by Ministry of Health, Labor and Welfare in Japan. In addition, study patients were divided into four groups based on these quartiles. We compared favorable neurological outcome at 30 days after OHCA in each group, using the multivariable logistic-regression analysis. Results: Four quartile ranges of the number of physicians were set for this study (Figure). Moreover, of the 629,471 OHCA victims between 2011 and 2015, 358,993 met the inclusion criteria. Figure represented favorable neurological outcome at 30 days after OHCA in each quartile. In the multivariable analysis, the adjusted odds ratios for Quartile 2, Quartile 3 and Quartile 4 compared with Quartile 1 for favorable neurological outcome at 30 days after OHCA was 0.971 (95%CI 0.918- 1.027; P=0.307), 1.011 (95%CI 0.956- 1.069; P=0.703) and 0.850 (95%CI 0.809- 0.893; P<0.001), respectively. Conclusion: The regions in which the number of physicians per 100000 population was larger were inferior to the regions in which the number of these was smaller, in terms of neurological benefits in patients with OHCA due to cardiac etiology.

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Abstract 25: Cost-Effectiveness of Public Automated External Defibrillators

Circulation ◽

10.1161/circ.138.suppl_2.25 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Lars W Andersen ◽

Mathias J Holmberg ◽

Asger Granfeldt ◽

Lyndon P James ◽

Lisa Caulley

Keyword(s):

Public Health ◽

Cardiac Arrest ◽

Cost Effectiveness ◽

Incremental Cost ◽

Cost Effective ◽

Incremental Cost Effectiveness Ratio ◽

Cost Effectiveness Ratio ◽

Automated External Defibrillators ◽

The Us ◽

Hospital Cardiac Arrest

Introduction: Despite a consistent association with improved outcomes, automated external defibrillators (AEDs) are used in only approximately 10% of public out-of-hospital cardiac arrest. One of the barriers towards increased use might be cost. The objective of this study was to provide a contemporary cost-effectiveness analysis on the use of public AEDs in the United States (US) to inform guidelines and public health initiatives. Methods: We compared the cost-effectiveness of public AEDs to no AEDs for out-of-hospital cardiac arrest in the US over a life-time horizon. The analysis assumed a societal perspective and results are presented as costs (in 2017 US dollars) per quality-adjusted life year (QALY). Model inputs were based on reviews of the literature. For the base case, we modelled an annual cardiac arrest incidence per AED of 20%. It was assumed that AED use was associated with a 52% relative increase in survival to hospital discharge with a favorable neurological outcome in those with a shockable rhythm. A probabilistic sensitivity analysis was conducted to account for joint parameter uncertainty. Consistent with recent guidelines from the American Heart Association, we used a willingness-to-pay threshold of $150,000 per QALY gained. Results: The no AED strategy resulted in 1.63 QALYs at a cost of $42,757. The AED strategy yielded an additional 0.26 QALYs for an incremental increase in cost of $13,793 per individual. The AED strategy yielded an incremental cost-effectiveness ratio of $53,797 per QALY gained. The yearly incidence of cardiac arrests occurring in the presence of an AED had minimal effect on the incremental cost-effectiveness ratio except at very low incidences. At an incidence of 1%, the incremental cost-effectiveness ratio was $101,040 per QALY gained. In sensitivity analyses across a plausible range of health-care and societal estimates, the AED strategy remained cost-effective. In the probabilistic sensitivity analysis, the AED strategy was cost-effective in 43%, 85%, and 91% of the scenarios at a threshold of $50,000, $100,000, and $150,000 per QALY gained, respectively. Conclusion: Public AEDs are a cost-effective public health intervention in the US. These findings support widespread dissemination of public AEDs.

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Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a registry study

European Heart Journal ◽

10.1093/eurheartj/ehz753 ◽

2019 ◽

Vol 41 (21) ◽

pp. 1961-1971 ◽

Cited By ~ 24

Author(s):

Wulfran Bougouin ◽

Florence Dumas ◽

Lionel Lamhaut ◽

Eloi Marijon ◽

Pierre Carli ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Conditional Logistic Regression ◽

Time Duration ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Factors Associated ◽

Hospital Survival ◽

Initial Rhythm ◽

Hospital Cardiac Arrest ◽

Extracorporeal Cpr

Abstract Aims Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes. Methods and results We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8–2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5–1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5–10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1–4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5–5.9; P = 0.002). Conclusions In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.

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Relationship of Humidity and Atmospheric Pressure With the Risk of Out-of-hospital Cardiac Arrest

Journal of Holistic Nursing and Midwifery ◽

10.32598/jhnm.30.4.2036 ◽

2020 ◽

Vol 30 (4) ◽

pp. 224-232

Author(s):

Yasaman Borghei ◽

Mohammad Taghi Moghadamnia ◽

Abdolhossein Emami Sigaroudi ◽

Ehsan Kazemnezhad Leili

Keyword(s):

Climate Change ◽

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Atmospheric Pressure ◽

Meteorological Data ◽

Weather Conditions ◽

Early Warning Systems ◽

Increased Risk ◽

Medical Care Team ◽

Hospital Cardiac Arrest

Introduction: Climate change, which affects human health, is one of the most important public health concerns. Few studies have examined the effects of humidity and atmospheric pressure as risk factors on the cardiac system and Out-of-hospital Cardiac Arrest. Objective: This study aimed to determine the relationship between climatic variables (humidity and atmospheric pressure) with Out-of-hospital Cardiac Arrest , and its outcome over 3 years (2016-2018). Materials and Methods: This is an ecological time-series study. Participants were 392 patients with Out-of-hospital Cardiac Arrest referred to Hospital in Rasht City, Iran from 2016 to 2018. Meteorological data and information related to Out-of-hospital Cardiac Arrest and its consequences were collected from reliable resources and were analyzed in R software. Results: Low humidity increased the relative risk of Out-of-hospital Cardiac Arrest (OR=1.54, 95%CI: 1.001-2.69, P=0.001) and failed cardiopulmonary resuscitation (OR=1.76, 95% CI; 1.006-3.79, P=0.001). Higher atmospheric pressure was associated with increased risk of Out-of-hospital Cardiac Arrest (OR=1.16, 95%CI; 1.001-1.78, P=0.001) and unsuccessful cardiopulmonary resuscitation (OR=1.039, 95% CI; 1.005-1.91, P=0.001). Conclusion: Decreased humidity and increased atmospheric pressure are associated with an increased number of Out-of-hospital Cardiac Arrest cases and failure of cardiopulmonary resuscitation. Informing people with cardiovascular disease to avoid such weather conditions, as well as preparing the medical care team and designing early warning systems, can reduce the adverse effects of climate change on the heart.

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DISPATCHER-ASSISTED CARDIOPULMONARY RESUSCITATION — AN EFFICIENT WAY FOR IMPROVING SURVIVAL AFTER OUT-OFHOSPITAL CARDIAC ARREST

EMERGENCY MEDICAL CARE ◽

10.24884/2072-6716-2018-19-4-10-16 ◽

2019 ◽

Vol 19 (4) ◽

pp. 10-16

Author(s):

A. A. Birkun

Keyword(s):

Public Health ◽

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Emergency Medical Services ◽

Hospital Care ◽

Human Life ◽

Potential Barriers ◽

Leading Role ◽

Bystander Cpr ◽

Hospital Cardiac Arrest

Immediate witnesses of out-of-hospital cardiac arrest (OHCA) play the leading role in supporting human life. In cases when basic cardiopulmonary resuscitation (CPR) is not performed by the bystanders, precipitous hypoxia brings chances for recovery almost to zero by the time of emergency medical services (EMS) arrival. Carrying out CPR following the instructions given by EMS dispatcher over the telephone (T-CPR) is the fastest and most efficient way of increasing bystander CPR rates. Implementation of T-CPR programs is proved to increase survival from OHCA. Consequently, T-CPR is defined by the effective guidelines for resuscitation as an essential component of pre-hospital care. This review discusses the modern approaches to organizing and implementing T-CPR programs, as well as potential barriers and international experience of T-CPR implementation. The paper is meant for EMS directors and managers, EMS dispatchers and public health specialists.

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Abstract 119: Association of Acute Exposure to Ambient Air Particulate Matter and Ozone with Risk of Out-of-hospital Cardiac Arrest

Circulation ◽

10.1161/circ.142.suppl_4.119 ◽

2020 ◽

Vol 142 (Suppl_4) ◽

Author(s):

Ali Malik ◽

Philip Jones ◽

Robert Brook ◽

Andy T Tran ◽

Paul S Chan

Keyword(s):

Cardiac Arrest ◽

Particulate Matter ◽

Moving Average ◽

Conditional Logistic Regression ◽

Ambient Air ◽

Acute Exposure ◽

Ozone Exposure ◽

Ozone Level ◽

Hospital Cardiac Arrest ◽

The U.S

Introduction: Acute exposure to particulate matter < 2.5 μm in diameter (PM 2.5 ) and ozone have been associated with increased all-cause mortality in the U.S. Whether these ambient air pollutants are specifically associated with a higher risk of out-of-hospital cardiac arrest (OHCA) is unknown. Methods: Within the Cardiac Arrest Registry to Enhance Survival, we identified 187,047 individuals with non-traumatic OHCA during 2013-2016 that could be linked to EPA data. We estimated an individual’s exposure to PM 2.5 and ozone using data from the EPA’s Fused Air Quality Surface using a Downscaling tool, which integrates monitoring station data with atmospheric models to predict daily levels by census tract. The associations of acute exposure to PM 2.5 and ozone with OHCA were examined using a time-stratified case-crossover design. Case day was defined as the day of the OHCA. Associations were also assessed for moving average across days 0-1 (lag 1) and days 0-2 (lag 2). Control days were defined as the same weekday from the preceding 2 weeks. Associations were estimated using conditional logistic regression on PM 2.5 and ozone, stratified by patient. We also explored if associations varied by age, sex, race and OHCA rhythm. Results: Mean age was 62.6 ± 19.4 years, 61.1% were male, and 52.6% non-White. Mean pollutant concentrations on case day were 9.2 ± 4.9 μg/m 3 PM 2.5 and 36.9 ± 12.1 parts per billion (ppb) ozone. We found a significant effect of ozone on the case day with a 1.1% increase in odds of OHCA per +12 ppb greater ozone level. There was no association with PM 2.5 on either case or lag days, and no association with ozone on lag days (Table). There was no interaction of age, sex, race and OHCA rhythm with PM 2.5 or ozone with risk of OHCA on either case or any lag days (p >0.2 for all). Conclusion: In the U.S. exposure to higher ozone levels, but not PM 2.5 , was associated with a higher risk of OHCA. Mechanisms by which acute ozone exposure increases risk need to be better defined.

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P4439Increased risk of out-of-hospital cardiac arrest in patients with psoriasis - a nationwide case-control study

European Heart Journal ◽

10.1093/eurheartj/ehz745.0840 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

G H Mohr ◽

C A Barcella ◽

K Kragholm ◽

S Rajan ◽

K B Sondergaard ◽

...

Keyword(s):

Cardiac Arrest ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Vascular Disease ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Case Control ◽

Ischemic Heart ◽

Hospital Cardiac Arrest ◽

Control Study

Abstract Background Chronic inflammatory disorders such as psoriasis have been associated with cardiovascular diseases and linked to proarrhythmogenic electrocardiographic changes, including QT-prolongation. However, evidence regarding the risk of out-of-hospital cardiac arrest with a history of psoriasis is lacking. Purpose To investigate the association between psoriasis and out-of-hospital cardiac arrest. Methods Through the nationwide Danish Cardiac Arrest Registry, we identified adult out-of-hospital cardiac arrest patients of presumed cardiac cause with and without psoriasis between June 2001 and December 2014. The odds of cardiac arrest were estimated using conditional logistic regression in a case-control design where we matched up to nine controls per case on age, sex and ischemic heart disease. The models were adjusted for comorbidities, concomitant pharmacotherapy and socioeconomic position. Results A total of 32,447 out-of-hospital cardiac arrest cases were included and matched with 291,999 controls from the general population. The median age was 72 years, 67% were male and 29% had ischemic heart disease. A total of 607 (1.9%) cases and 4662 (1.6%) controls had psoriasis. Compared with cardiac arrest cases without psoriasis, cases with psoriasis had same age (p=0.718) and gender distribution (p=0.794), higher prevalence of comorbidities such as congestive heart failure (25.7% vs 20.2%, p=0.001), chronic kidney disease (8.9% vs 6.2%, p=0.008) and chronic obstructive pulmonary disease (19.0% vs 14.7%, p=0.005) but had same prevalence of cerebral vascular disease (15.8% vs 14.5%, p=0.351) and peripheral vascular disease (13.3% vs 11.1%, p=0.078). In unadjusted and adjusted analyses, psoriasis was significantly associated with increased odds of cardiac arrest (odds ratio (OR) 1.18 [95% confidence interval (CI) 1.08–1.28] and OR 1.13 [95% CI 1.04–1.23], respectively) (Figure 1). Conclusion In this nationwide case-control study, psoriasis was significantly associated with increased odds of out-of-hospital cardiac arrest. Focus on risk factors and prevention of cardiovascular disease in patients with psoriasis is warranted. Acknowledgement/Funding None

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Extreme temperature and out-of-hospital-cardiac-arrest. Nationwide study in a hot climate country

Environmental Health ◽

10.1186/s12940-021-00722-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Hannan Kranc ◽

Victor Novack ◽

Alexandra Shtein ◽

Rimma Sherman ◽

Lena Novack

Keyword(s):

Adverse Effect ◽

Cardiac Arrest ◽

Conditional Logistic Regression ◽

Extreme Temperature ◽

Heat Index ◽

Prevention Measures ◽

Climate Conditions ◽

Excessive Heat ◽

Ambient Exposure ◽

Hospital Cardiac Arrest

Abstract Background Out-of-hospital-cardiac arrest (OHCA) is frequently linked to environmental exposures. Climate change and global warming phenomenon have been found related to cardiovascular morbidity, however there is no agreement on their impact on OHCA occurrence. In this nationwide analysis, we aimed to assess the incidence of the OHCA events attended by emergency medical services (EMS), in relation to meteorological conditions: temperature, humidity, heat index and solar radiation. Methods We analyzed all adult cases of OHCA in Israel attended by EMS during 2016–2017. In the case-crossover design, we compared ambient exposure within 72 h prior to the OHCA event with exposure prior to the four control times using conditional logistic regression in a lag-distributed non-linear model. Results There were 12,401 OHCA cases (68.3% were pronounced dead-on-scene). The patients were on average 75.5 ± 16.2 years old and 55.8% of them were males. Exposure to 90th and 10th percentile of temperature adjusted to humidity were positively associated with the OHCA with borderline significance (Odds Ratio (OR) =1.20, 95%CI 0.97; 1.49 and OR 1.16, 95%CI 0.95; 1.41, respectively). Relative humidity below the 10th percentile was a risk factor for OHCA, independent of temperature, with borderline significance (OR = 1.16, 95%CI 0.96; 1.38). Analysis stratified by seasons revealed an adverse effect of exposure to 90th percentile of temperature when estimated in summer (OR = 3.34, 95%CI 1.90; 3.5.86) and exposure to temperatures below 10th percentile in winter (OR = 1.75, 95%CI 1.23; 2.49). Low temperatures during a warm season and high temperatures during a cold season had a protective effect on OHCA. The heat index followed a similar pattern, where an adverse effect was demonstrated for extreme levels of exposure. Conclusions Evolving climate conditions characterized by excessive heat and low humidity represent risk factors for OHCA. As these conditions are easily avoided, by air conditioning and behavioral restrictions, necessary prevention measures are warranted.

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A SARS-CoV-2-járvány hatása a kórházon kívüli és belüli szívmegállásra

Orvosi Hetilap ◽

10.1556/650.2021.32381 ◽

2021 ◽

Vol 162 (46) ◽

pp. 1831-1841

Author(s):

Alexandra Fekete-Győr ◽

Enikő Kovács ◽

Boldizsár Kiss ◽

Endre Zima

Keyword(s):

Public Health ◽

Cardiac Arrest ◽

Response Times ◽

Healthcare Services ◽

Spontaneous Circulation ◽

Published Data ◽

Health Measures ◽

New Public Health ◽

The Impact ◽

Hospital Cardiac Arrest

Összefoglaló. A koronavírus-betegség (COVID–19) okozta közvetlen mortalitáson túl, a járvány közvetett úton is hatással lehet a hirtelen szívhalálra. Egyre növekvő számú közlemény foglalkozik a járványnak a hirtelen szívhalálra kifejtett közvetett hatásával. A kijárási korlátozások és az egészségügyi rendszerek átszervezése hozzájárulhatott ahhoz, hogy a járvány alatt mind a kórházon kívüli, mind a kórházon belüli szívhalál előfordulása megemelkedett. Közegészségügyi intézkedések, mint a korlátozások és a kórházak átszervezése, megváltoztathatják az egészségügyi szolgáltatásokhoz való hozzáférést, ezért hozzájárulhattak az elmúlt évben tapasztalt emelkedett számú szívmegálláshoz. Közleményünk célja a SARS-CoV-2-járvány hirtelen szívhalálra kifejtett hatására vonatkozó, a nemzetközi irodalomban jelenleg megtalálható tanulmányok összefoglalása, melyek a kórházon kívüli szívmegállás előfordulásának háromszoros emelkedéséről számoltak be a járványt megelőző évhez képest. Általánosságban elmondható, hogy a kórházon kívüli szívmegállás a járvány ideje alatt nagyobb gyakorisággal járt nem sokkolandó ritmussal, hosszabb idő telt el a mentők kiérkezéséig, alacsonyabb volt a szemtanú által megkezdett újraélesztés, a spontán keringés visszatérésének, valamint a kórházi elbocsátásnak a gyakorisága. A járványnak a kórházon belüli szívmegállásra kifejtett hatása kevésbé vizsgált az irodalomban. Míg a hirtelen szívhalált követő mortalitás néhány kutatásban jelentős emelkedést mutatott, addig máshol nem volt különbség a járványt megelőző időszakhoz képest. A COVID–19-pandémia ideje alatt jelentősen megnövekedett kórházon kívüli és belüli szívmegállás hátterében a járványnak közvetett úton is szerepe lehet, a fertőzés közvetlen hatása mellett. A túlélési lánc megbomlását számos helyen tapasztalták, ami hozzájárulhatott a kedvezőtlen kimenetelhez. Mind a prehospitális, mind pedig a hospitális ellátás gyakorlatában bekövetkező jelentős változások magyarázhatják a világ különböző pontjain megfigyelt eltéréseket. Orv Hetil. 2021; 162(46): 1831–1841. Summary. The direct effect of COVID-19 on mortality through acute respiratory failure is well-established. However, there are a growing number of publications suggesting that the prevalence and outcome of sudden cardiac death may also be indirectly affected by the pandemic. Public health measures, such as lockdowns and reorganisation of hospitals, can alter the access to healthcare services and therefore might have contributed to the excess number of cardiac arrests which were seen over the last year. Our aim was to review the currently available publications regarding the impact of the COVID-19 pandemic on out-of-hospital and in-hospital cardiac arrests. A recent study reported a 3-fold growth in the incidence of out-of-hospital cardiac arrests during the 2020 COVID-19 period compared to the year before. In general, the number of non-shockable rhythms increased, bystander-witnessed cases and bystander-initiated cardiopulmonary resuscitation were reduced and ambulance response times were significantly delayed during the pandemic. Return of spontaneous circulation and survival to discharge substantially decreased compared to the time before the pandemic. The difference between the rate of mortality following in-hospital cardiac arrest during and before the pandemic is controversial according to published data. The incidence of out-of-hospital and in-hospital cardiac arrests significantly increased during the pandemic compared to previous years suggesting direct effects of COVID-19 infection and indirect effects from new public health measures. The disruption of the chain of survival could have contributed to the increased mortality following out-of-hospital cardiac arrest. Orv Hetil. 2021; 162(46): 1831–1841.

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