Does the position of the body impact the return of spontaneous circulation and hospital survival in sudden cardiac arrest patients?

Abstract

Introduction: Out-of-hospital cardiac arrest (OHCA) is a big medical problem. Material and methods: The aim of this study was to assess the occurrence of sitting position in victims of OHCA at the arrival of Emergency Medical Services (EMS) and examine whether maintaining a supine position until ambulance arrival impacts the return of spontaneous circulation (ROSC) and survival until hospital admission and discharge. The documentation of patients in the OHCA registry of part of Silesian Voivodeship 1–06.2018 was accessed and yielded 634 cases for analysis. Results: The sitting position was found in 41 (6.5%) patients. These patients were more frequently female: 46.3% vs 30.6%, and older: 74.0 (57.9–82.0) vs 67.7 (54.9–75.8) and less frequently received cardiopulmonary resuscitation (CPR) from bystanders: 7.3% vs 63.6%, while ROSC was found with similar frequency: 34.2% vs 34.1%, survival until hospital admission in ROSC subgroups was lower in those in a sitting position than in a lying position: 50% vs 75.5%. None patients who were found in the sitting position survived until hospital discharge, while 33 (6.1%) patients out of those found in the lying positions survived. The univariable analysis showed that the sitting position was associated with female sex, older age, previously implanted implantable cardioverter-defibrillator (ICD) before OHCA. The multivariable logistic revealed that the sitting position was independently associated with chest pain and the presence of ICD. Conclusions: Patients found in a sitting position at the arrival of EMS constituted 6.5% of patients with OHCA in whom resuscitation attempts were undertaken and were at higher risk of unfavorable outcomes.