Mortality Factors in Out-of-Hospital Cardiac Arrest Patients: A Nationwide Population-based Study in Taiwan

Abstract

Survival after an out-of-hospital cardiac arrest (OHCA) depends on the integrity of the community chain of survival, including optimal and high-quality CPR, early defibrillation, and postresuscitation care. Older OHCA patients may have worse outcomes than the younger ones. This study aimed to find out the influence of age and other factors on the outcomes of OHCAs. We analyzed the original claims data of the National Health Insurance from 2005 to 2007, and identified all patients who were sent to the emergency department with OHCA. Traumatic OHCA patients and patients without codes for intubation and CPR were excluded. Survival rates between the different groups were identified. Factors such as age, sex, pre-existing comorbidities, and different hospital levels were adjusted in a logistic regression model for survival. A total of 1673 OHCA cases were identified. Overall, the 1-month survival rates were similar in each year. However, the survival rates for those who were treated in medical centers improved from 3.4% (2005) to 6.8% (2007) ( p < 0.01). Of all OHCA patients admitted to the emergency room, patients older than 75 years of age had significantly worse survival rates. Patients with the same profile, but who were admitted to hospitals, had nonsignificant worse survival rates. Our study shows that age is no longer an important factor for survival in admitted patients. In addition, medical centers are better for the OHCA patients, after adjusting for other factors. This finding suggests that we still need to try our best to treat older OHCA patients without discrimination.