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

218 Scopus citations

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<. 0.001). Conclusions: ROC-wide survival increased significantly between 2006 and 2010. Additional research efforts are warranted to identify specific factors associated with this improvement.

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

    Fingerprint

Keywords

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

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this