176. Out-of-hospital cardiac arrests in the Gulf region: a scoping review.

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) is a major cause of mortality worldwide. Survival rates from OHCA vary drastically around the world. Recent studies have demonstrated low survival rates in Saudi Arabia, the United Arab Emirates (UAE) and Qatar. However, there remains a paucity of data published on OHCA in the Gulf Cooperation Council (GCC) region, and the issue is poorly understood as a whole. Anecdotally and from our experience, there are unique demographic, cultural and logistical challenges related to the management of OHCA in the region. As a result, evidence produced in Western systems can be challenged when attempts are made to directly translate it to systems in the region. In order to begin to address OHCA in a meaningful manner in the region, we first need to quantify the issue. Methods: A scoping study using Arksey and O’Malley’s approach was used to synthesise the evidence (published and grey literature) on OHCA in the GCC region. A scoping study was identified as the most appropriate approach due to the predicted lack of published data, the anticipated heterogeneity among study characteristics, and variances in reporting. Several electronic databases were searched from 1990 onwards. Non-indexed journals in the region were identified and searched, and multiple Google and Google Scholar searches were conducted. Several subject matter experts in the region were also consulted. All types of studies were included with no language restrictions applied. Results: A total of 22 studies were included in the review from Saudi Arabia, the UAE, Oman, Kuwait, and Qatar. Three of these were reports or theses (that were later described in peer-reviewed articles), three were abstracts, and one was a letter to the editor, with the remaining 15 comprised of articles (published and unpublished). No literature was identified from the state of Bahrain. OHCA victims in the GCC region are consistently younger, predominantly male, and more co-morbid than their counterparts in Western studies. We observed low levels of EMS utilisation, low bystander cardiopulmonary resuscitation (CPR) rates, low return of spontaneous circulation (ROSC) rates, and lower levels of survival to hospital discharge across the region when compared to Western studies. There are notable differences in the characteristics of OHCA among different ethnic groups in the region (e.g. Arab, South Asian and North African). Survival rates for paediatric OHCA were low. Discussion: This study is the first of its kind to collate data on OHCA in the GCC region. It has highlighted unique demographical traits related to OHCA populations in the region. In addition, we have attempted to outline some of the challenges related to OHCA management in the region. The study findings may help to inform the design of initiatives and systems to identify and manage OHCA in the GCC region. It may also aid in the identification of issues related to knowledge translation from Western systems, and assist in the identification of priority areas for future research.