Abstract 14500: Association Between the Arrival Time of Paramedics and the Neurological Outcome at Discharge of Cardiac Arrest Patients

Abstract

Introduction: Improving survival rate and neurological outcome of out-of-hospital cardiac arrest (OHCA) patients is a global public health challenge. Prompt and appropriate management by emergency medical service at the prehospital stage is essential to achieve a good outcome in OHCA patients. Hypothesis We hypothesized that the arrival time of the second ambulance may affect the prognosis of patients with cardiac arrest, and this study aimed to investigate the relationship between the arrival time of last-arrival ambulance and the neurological outcome at discharge. Methods This study was a retrospective analysis of a prospectively collected registry of OHCA patients. Adult non-traumatic OHCA patients from Jan 2017 to Dec 2018 were included. ROC analysis was performed for good neurological outcomes, according to the arrival time of the last-arrival ambulance. Comparing the early arrival team (response time of last-arrival ambulance less than 14 minutes) and the late arrival team (response time of last-arrival ambulance 14 minutes or longer) with propensity score matching. Results A total 3,289 OHCA patients from 12 cities of Gyeonggi province, metropolitan area located in the suburbs of the capital of Republic of Korea was included. optimal cut off was 14 minutes. After propensity score matching, Survival to admission, survival discharge and good neurological outcome were higher in the early arrival team than the late arrival team [26.1% versus 21.3, 12.6% versus 6.3% and 7.1% versus 3.2%]. The response time of last-arrival team 14-minute or longer group showed a significant association with poor neurological outcomes at discharge compared to the group with less than 14 minutes [Odds ratio 2.87, 95% confidence interval 1.65-5.11, P value < 0.001]. Conclusion In two-tier ambulance system, response time of last-arrival team 14-minute or longer was associated with poor neurological outcomes upon discharge in out-of-hospital cardiac arrest patients.