Neurological outcomes after an out-of-hospital cardiac arrest among people living in high-rise buildings in South Korea.

Abstract

Living in high-rise buildings may cause delays in reaching a hospital after an out-of-hospital cardiac arrest. This study aimed to compare neurological outcomes in people who had had an out-of-hospital cardiac arrest, according to their floor of residence. We conducted a retrospective study of 1541 patients aged ≥20 years who had out-of-hospital cardiac arrest between 1 October 2015 and 30 June 2018, using data from a central registry. We compared the outcomes of patients living on the first (ground) or second floor and those living on the third floor or above, using multiple logistic regression. Those living on higher floors were more likely to have been at home (88.1% vs. 58.0%); to have had bystander cardiopulmonary resuscitation (57.9% vs. 45.2%); and experienced a significantly longer emergency medical service response time [median interquartile range (IQR): 7 min (6-10 min) vs. 7 min (5-9 min), P = 0.001] and on-scene time [median (IQR): 16 min (11-23 min) vs. 12 min (8-19 min), P < 0.001]. The strongest predictors of a good neurological outcome were younger age [odds ratio (OR): 0.96, 95% confidence interval (CI): 0.94-0.97], being on a lower floor at the time of the cardiac arrest (OR: 1.82, 95% CI: 1.09-3.12) and having a shockable rhythm (OR: 21.97, 95% CI: 12.81-39.47). People living on higher floors have poorer outcomes after an out-of-hospital cardiac arrest. Further studies are required to assess factors causing a delay in the emergency medical service response time, and placement of automated external defibrillators in high-rise buildings.