Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 7;21(1):3.
doi: 10.1186/s12873-020-00400-4.

Association between prehospital prognostic factors on out-of-hospital cardiac arrest in different age groups

Jyun-Bin Huang  1 , Kuo-Hsin Lee  2   3 , Yu-Ni Ho  1 , Ming-Ta Tsai  1 , Wei-Ting Wu  1 , Fu-Jen Cheng  4
Affiliations

Association between prehospital prognostic factors on out-of-hospital cardiac arrest in different age groups

Jyun-Bin Huang et al. BMC Emerg Med. .

Abstract

Background: The prognosis of out-of-hospital cardiac arrest (OHCA) is very poor. While several prehospital factors are known to be associated with improved survival, the impact of prehospital factors on different age groups is unclear. The objective of the study was to access the impact of prehospital factors and pre-existing comorbidities on OHCA outcomes in different age groups.

Methods: A retrospective observational analysis was conducted using the emergency medical service (EMS) database from January 2015 to December 2019. We collected information on prehospital factors, underlying diseases, and outcome of OHCAs in different age groups. Kaplan-Meier type survival curves and multivariable logistic regression were used to analyze the association between modifiable pre-hospital factors and outcomes.

Results: A total of 4188 witnessed adult OHCAs were analyzed. For the age group 1 (age ≦75 years old), after adjustment for confounding factors, EMS response time (odds ratio [OR] = 0.860, 95% confidence interval [CI]: 0.811-0.909, p < 0.001), public location (OR = 1.843, 95% CI: 1.179-1.761, p < 0.001), bystander CPR (OR = 1.329, 95% CI: 1.007-1.750, p = 0.045), attendance by an EMT-Paramedic (OR = 1.666, 95% CI: 1.277-2.168, p < 0.001), and prehospital defibrillation by automated external defibrillator (AED)(OR = 1.666, 95% CI: 1.277-2.168, p < 0.001) were prognostic factors for survival to hospital discharge in OHCA patients. For the age group 2 (age > 75 years old), age (OR = 0.924, CI:0.880-0.966, p = 0.001), EMS response time (OR = 0.833, 95% CI: 0.742-0.928, p = 0.001), public location (OR = 4.290, 95% CI: 2.450-7.343, p < 0.001), and attendance by an EMT-Paramedic (OR = 2.702, 95% CI: 1.704-4.279, p < 0.001) were independent prognostic factors for survival to hospital discharge in OHCA patients.

Conclusions: There were variations between younger and older OHCA patients. We found that bystander CPR and prehospital defibrillation by AED were independent prognostic factors for younger OHCA patients but not for the older group.

Keywords: Age; Bystander CPR; Defibrillation; Out-of-hospital cardiac arrest; Prehospital.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan Meier type survival curves for out-of-hospital cardiac arrest patients stratified by bystander CPR in different age groups. a Group 1 (Age ≦75); b Group 2 (Age > 75)
Fig. 2
Fig. 2
Kaplan Meier type survival curves for out-of-hospital cardiac arrest patients stratified by prehospital defibrillation by AED in different age groups. a Group 1; b Group 2
See this image and copyright information in PMC

References

    1. Shin SD, et al. Comparison of emergency medical services systems across Pan-Asian countries: a Web-based survey. Prehosp Emerg Care. 2012;16(4):477–496. doi: 10.3109/10903127.2012.695433. - DOI - PubMed
    1. Ho AFW, et al. Outcomes and modifiable resuscitative characteristics amongst pan-Asian out-of-hospital cardiac arrest occurring at night. Medicine (Baltimore) 2019;98(10):e14611. doi: 10.1097/MD.0000000000014611. - DOI - PMC - PubMed
    1. Mathiesen WT, et al. Effects of modifiable prehospital factors on survival after out-of-hospital cardiac arrest in rural versus urban areas. Crit Care. 2018;22(1):99. doi: 10.1186/s13054-018-2017-x. - DOI - PMC - PubMed
    1. Hamilton A, et al. Association between prehospital physician involvement and survival after out-of-hospital cardiac arrest: A Danish nationwide observational study. Resuscitation. 2016;108:95–101. doi: 10.1016/j.resuscitation.2016.08.007. - DOI - PubMed
    1. Koyama S, et al. Variation in survival after out-of-hospital cardiac arrest between receiving hospitals in Japan: an observational study. BMJ Open. 2019;9(11):e033919. doi: 10.1136/bmjopen-2019-033919. - DOI - PMC - PubMed