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Comparative Study
. 2020 Jun 12;20(1):288.
doi: 10.1186/s12872-020-01571-5.

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland: a one-year retrospective study

Michał Czapla  1 , Marzena Zielińska  2 , Anna Kubica-Cielińska  3 , Dorota Diakowska  4 , Tom Quinn  5 , Piotr Karniej  1
Affiliations
Comparative Study

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland: a one-year retrospective study

Michał Czapla et al. BMC Cardiovasc Disord. .

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) is a common reason for calls for intervention by emergency medical teams (EMTs) in Poland. Regardless of the mechanism, OHCA is a state in which the chance of survival is dependent on rapid action from bystanders and responding health professionals in emergency medical services (EMS). We aimed to identify factors associated with return of spontaneous circulation (ROSC).

Methods: The medical records of 2137 EMS responses to OHCA in the city of Wroclaw, Poland between July 2017 and June 2018 were analyzed.

Results: The OHCA incidence rate for the year studied was 102 cases per 100,000 inhabitants. EMS were called to 2317 OHCA events of which 1167 (50.4%) did not have resuscitation attempted on EMS arrival. The difference between the number of successful and failed cardiopulmonary resuscitations (CPRs) was statistically significant (p < 0.001). Of 1150 patients in whom resuscitation was attempted, ROSC was achieved in 250 (27.8%). Rate of ROSC was significantly higher when CPR was initiated by bystanders (p < 0.001). Patients presenting with asystole or pulseless electrical activity (PEA) had a higher risk of CPR failure (86%) than those with ventricular fibrillation/ventricular tachycardia (VF/VT). Patients with VF/VT had a higher chance of ROSC (OR 2.68, 1.86-3.85) than those with asystole (p < 0.001). The chance of ROSC was 1.78 times higher when the event occurred in a public place (p < 0.001).

Conclusions: The factors associated with ROSC were occurrence in a public place, CPR initiation by witnesses, and presence of a shockable rhythm. Gender, age, and the type of EMT did not influence ROSC. Low bystander CPR rates reinforce the need for further efforts to train the public in CPR.

Keywords: Cardiopulmonary resuscitation; Emergency medical services; Out-of-hospital cardiac arrest; Prehospital emergency care.

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Conflict of interest statement

Tom Quinn reports research funding from the UK National Institute for Health Research and British Heart Foundation. The remaining authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
The main data of out-of-hospital cardiac arrest (OHCA). Abbreviations: CPR: cardiopulmonary resuscitation; VF: ventricular fibrillation; VT: ventricular tachycardia; PEA: pulseless electrical activity; ROSC: return of spontaneous circulation
See this image and copyright information in PMC

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