Out-of-hospital cardiac arrest survival improving over time

Results from the Resuscitation Outcomes Consortium (ROC)

Resuscitation Outcomes Consortium Investigators

Research output: Contribution to journalArticle

193 Citations (Scopus)

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death and a 2010 meta-analysis concluded that outcomes have not improved over several decades. However, guidelines have changed to emphasize CPR quality, minimization of interruptions, and standardized post-resuscitation care. We sought to evaluate whether OHCA outcomes have improved over time among agencies participating in the Resuscitation Outcomes Consortium (ROC) cardiac arrest registry (Epistry) and randomized clinical trials (RCTs). Methods: Observational cohort study of 47,148 EMS-treated OHCA cases in Epistry from 139 EMS agencies at 10 ROC sites that participated in at least one RCT between 1/1/2006 and 12/31/2010. We reviewed patient, scene, event characteristics, and outcomes of EMS-treated OHCA over time, including subgroups with initial rhythm of pulseless ventricular tachycardia or ventricular fibrillation (VT/VF). Results: Mean response interval, median age and male proportion remained similar over time. Unadjusted survival to discharge increased between 2006 and 2010 for treated OHCA (from 8.2% to 10.4%), as well as for subgroups of VT/VF (21.4% to 29.3%) and bystander witnessed VT/VF (23.5% to 30.3%). Compared with 2006, adjusted survival to discharge was significantly higher in 2010 for treated cases (OR. =. 1.72; 95% CI 1.53, 1.94), VT/VF cases (OR. =. 1.69; 95% CI 1.45, 1.98) and bystander witnessed VT/VF cases (OR. =. 1.65; 95% CI 1.36, 2.00). Tests for trend in each subgroup were significant (. p

Original languageEnglish (US)
Pages (from-to)108-115
Number of pages8
JournalResuscitation
Volume91
DOIs
StatePublished - Jun 1 2015

Fingerprint

Out-of-Hospital Cardiac Arrest
Ventricular Fibrillation
Ventricular Tachycardia
Resuscitation
Survival
Randomized Controlled Trials
Cardiopulmonary Resuscitation
Heart Arrest
Observational Studies
Registries
Meta-Analysis
Cause of Death
Cohort Studies
Guidelines

Keywords

  • Emergency Medical Services (EMS)
  • Out-of-hospital cardiac arrest (OHCA)
  • Resucitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Out-of-hospital cardiac arrest survival improving over time : Results from the Resuscitation Outcomes Consortium (ROC). / Resuscitation Outcomes Consortium Investigators.

In: Resuscitation, Vol. 91, 01.06.2015, p. 108-115.

Research output: Contribution to journalArticle

@article{ecd68ae0918b4e6d9fabc932526422b4,
title = "Out-of-hospital cardiac arrest survival improving over time: Results from the Resuscitation Outcomes Consortium (ROC)",
abstract = "Background: Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death and a 2010 meta-analysis concluded that outcomes have not improved over several decades. However, guidelines have changed to emphasize CPR quality, minimization of interruptions, and standardized post-resuscitation care. We sought to evaluate whether OHCA outcomes have improved over time among agencies participating in the Resuscitation Outcomes Consortium (ROC) cardiac arrest registry (Epistry) and randomized clinical trials (RCTs). Methods: Observational cohort study of 47,148 EMS-treated OHCA cases in Epistry from 139 EMS agencies at 10 ROC sites that participated in at least one RCT between 1/1/2006 and 12/31/2010. We reviewed patient, scene, event characteristics, and outcomes of EMS-treated OHCA over time, including subgroups with initial rhythm of pulseless ventricular tachycardia or ventricular fibrillation (VT/VF). Results: Mean response interval, median age and male proportion remained similar over time. Unadjusted survival to discharge increased between 2006 and 2010 for treated OHCA (from 8.2{\%} to 10.4{\%}), as well as for subgroups of VT/VF (21.4{\%} to 29.3{\%}) and bystander witnessed VT/VF (23.5{\%} to 30.3{\%}). Compared with 2006, adjusted survival to discharge was significantly higher in 2010 for treated cases (OR. =. 1.72; 95{\%} CI 1.53, 1.94), VT/VF cases (OR. =. 1.69; 95{\%} CI 1.45, 1.98) and bystander witnessed VT/VF cases (OR. =. 1.65; 95{\%} CI 1.36, 2.00). Tests for trend in each subgroup were significant (. p",
keywords = "Emergency Medical Services (EMS), Out-of-hospital cardiac arrest (OHCA), Resucitation",
author = "{Resuscitation Outcomes Consortium Investigators} and Daya, {Mohamud Ramzan} and Schmicker, {Robert H.} and Dana Zive and Rea, {Thomas D.} and Graham Nichol and Buick, {Jason E.} and Steven Brooks and Jim Christenson and Renee MacPhee and Alan Craig and Rittenberger, {Jon C.} and Davis, {Daniel P.} and Susanne May and Jane Wigginton and Henry Wang",
year = "2015",
month = "6",
day = "1",
doi = "10.1016/j.resuscitation.2015.02.003",
language = "English (US)",
volume = "91",
pages = "108--115",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Out-of-hospital cardiac arrest survival improving over time

T2 - Results from the Resuscitation Outcomes Consortium (ROC)

AU - Resuscitation Outcomes Consortium Investigators

AU - Daya, Mohamud Ramzan

AU - Schmicker, Robert H.

AU - Zive, Dana

AU - Rea, Thomas D.

AU - Nichol, Graham

AU - Buick, Jason E.

AU - Brooks, Steven

AU - Christenson, Jim

AU - MacPhee, Renee

AU - Craig, Alan

AU - Rittenberger, Jon C.

AU - Davis, Daniel P.

AU - May, Susanne

AU - Wigginton, Jane

AU - Wang, Henry

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background: Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death and a 2010 meta-analysis concluded that outcomes have not improved over several decades. However, guidelines have changed to emphasize CPR quality, minimization of interruptions, and standardized post-resuscitation care. We sought to evaluate whether OHCA outcomes have improved over time among agencies participating in the Resuscitation Outcomes Consortium (ROC) cardiac arrest registry (Epistry) and randomized clinical trials (RCTs). Methods: Observational cohort study of 47,148 EMS-treated OHCA cases in Epistry from 139 EMS agencies at 10 ROC sites that participated in at least one RCT between 1/1/2006 and 12/31/2010. We reviewed patient, scene, event characteristics, and outcomes of EMS-treated OHCA over time, including subgroups with initial rhythm of pulseless ventricular tachycardia or ventricular fibrillation (VT/VF). Results: Mean response interval, median age and male proportion remained similar over time. Unadjusted survival to discharge increased between 2006 and 2010 for treated OHCA (from 8.2% to 10.4%), as well as for subgroups of VT/VF (21.4% to 29.3%) and bystander witnessed VT/VF (23.5% to 30.3%). Compared with 2006, adjusted survival to discharge was significantly higher in 2010 for treated cases (OR. =. 1.72; 95% CI 1.53, 1.94), VT/VF cases (OR. =. 1.69; 95% CI 1.45, 1.98) and bystander witnessed VT/VF cases (OR. =. 1.65; 95% CI 1.36, 2.00). Tests for trend in each subgroup were significant (. p

AB - Background: Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death and a 2010 meta-analysis concluded that outcomes have not improved over several decades. However, guidelines have changed to emphasize CPR quality, minimization of interruptions, and standardized post-resuscitation care. We sought to evaluate whether OHCA outcomes have improved over time among agencies participating in the Resuscitation Outcomes Consortium (ROC) cardiac arrest registry (Epistry) and randomized clinical trials (RCTs). Methods: Observational cohort study of 47,148 EMS-treated OHCA cases in Epistry from 139 EMS agencies at 10 ROC sites that participated in at least one RCT between 1/1/2006 and 12/31/2010. We reviewed patient, scene, event characteristics, and outcomes of EMS-treated OHCA over time, including subgroups with initial rhythm of pulseless ventricular tachycardia or ventricular fibrillation (VT/VF). Results: Mean response interval, median age and male proportion remained similar over time. Unadjusted survival to discharge increased between 2006 and 2010 for treated OHCA (from 8.2% to 10.4%), as well as for subgroups of VT/VF (21.4% to 29.3%) and bystander witnessed VT/VF (23.5% to 30.3%). Compared with 2006, adjusted survival to discharge was significantly higher in 2010 for treated cases (OR. =. 1.72; 95% CI 1.53, 1.94), VT/VF cases (OR. =. 1.69; 95% CI 1.45, 1.98) and bystander witnessed VT/VF cases (OR. =. 1.65; 95% CI 1.36, 2.00). Tests for trend in each subgroup were significant (. p

KW - Emergency Medical Services (EMS)

KW - Out-of-hospital cardiac arrest (OHCA)

KW - Resucitation

UR - http://www.scopus.com/inward/record.url?scp=84929276591&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84929276591&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2015.02.003

DO - 10.1016/j.resuscitation.2015.02.003

M3 - Article

VL - 91

SP - 108

EP - 115

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -