Abstract
Aims. To investigate the return of spontaneous circulation (ROSC), survival to discharge, six-month and one-year survival of patients with out-of-hospital cardiac arrest in four university cities in Serbia.Methods. A prospective, two-year, multicentre study was designed. Using the Utstein template, we recorded out-of-hospital cardiopulmonary (CPR) and its outcomes, and analyzed the immediate survival (ROSC>20 min.), short-term survival (to discharge), long-term survival (one year after discharge), or death following out-of-hospital CPR.Results. During the study period, 591 patients met the inclusion criteria for enrollment and out-of-hospital CPR. The etiology of arrest was cardiac in 33.8% of patients. Cardiac arrest was witnessed by the advanced life support (ALS) team in 15.6% of cases. Asystole was the most frequent initial rhythm at time of arrest (46.4%). The highest survival rate (P<0,001) was observed in cases with initial VF and pulseless VT, while patients with asystole and pulseless electrical activity (PEA) had the least chance of survival. Within the whole group of patients, ROSC was detected with a frequency of 69.7%. The frequency of patients who died in the field or during admission to hospital was 58.9%, while 28.6% of admitted patients died before discharge. Thirteen percent of patients survived until discharge, and the overall six-month and one-year survival rates were 11.3% and 10%, respectively. No statistical difference in survival rates among the cities was found Conclusion. The Utstein template should be implemented in the form of an official protocol for out-of-hospital CPR follow-up in all emergency medical services in Serbia.
Highlights
Sudden cardiac arrest is considered a leading cause of death in the world, accounting for 700,000 deaths annually in Europe alone
Within the whole group of patients, return of spontaneous circulation (ROSC) was detected with a frequency of 69.7%
The highest survival rate was observed in cases of VF and pulseless VT, while patients with asystole and pulseless electrical activity (PEA) had the least chance of survival
Summary
Sudden cardiac arrest is considered a leading cause of death in the world, accounting for 700,000 deaths annually in Europe alone. The results of previous studies investigating this phenomenon vary, as they have been conducted in different populations and with different types of emergency care, or investigated different types of cardiac arrest or different protocols. To overcome these problems, the so-called Utstein style has been created, representing the collection of uniform terms and definitions used for analyzing and reporting on out-ofhospital CPR. Utstein style analysis of rural out-of-hospital cardiac arrest >OOHCA@: total cardiopulmonary resuscitation (CPR) time inversely correlates with hospital discharge rate. Utstein style analysis of out-of-hospital cardiac arrest – where are bystander
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