Nineteen years' experience of out-of-hospital cardiac arrest in Gothenburg--reported in Utstein style

Abstract

Objective: To describe the outcome in the Utstein style for out of hospital cardiac arrest in Gothenburg, over a period of 19 years.

Methods: All consecutive cases of cardiac arrest between 1980 and 1999 in which the emergency medical service (EMS) system responded and attempted resuscitation were reported and followed up for 1 year.

Results: In all, there were 5270 attempts. 3871 (73%) of which were regarded as being of a cardiac aetiology. In these cases, information on witnessed status was missing in 782 cases (20%). Of the remaining 3089 cases, 2066 (67%) were bystander witnessed, 791 (26%) were unwitnessed and 232 (8%) crew witnessed. The median interval between a call for the ambulance and the arrival of the first ambulance was 5 min. Thirteen percent of the bystander-witnessed cases were discharged from hospital. Of the unwitnessed cases, only 2% were discharged from hospital, whereas 22% of the crew-witnessed cases were discharged. Of the patients with a bystander-witnessed cardiac arrest of a cardiac aetiology found in ventricular fibrillation (VF), 20% were discharged from hospital.

Conclusion: In this large Utstein style study of out of hospital cardiac arrest stretching over almost 19 years, we report high survival rates both for patients suffering a bystander-witnessed cardiac arrest, and for the subgroup suffering a bystander-witnessed cardiac arrest with VF as the first recorded rhythm. These high survival rates can in part be explained by the short time intervals from calls being received by the emergency dispatch centre (EDC) to the arrival of the emergency medical service at the scene.