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
. 2022 Sep 9;15(1):46.
doi: 10.1186/s12245-022-00444-2.

Characteristics and outcomes of out-of-hospital cardiac arrest patients before and during the COVID-19 pandemic in Thailand

Phatthranit Phattharapornjaroen  1 , Waratchaya Nimnuan  1 , Pitsucha Sanguanwit  2 , Pongsakorn Atiksawedparit  3 , Malivan Phontabtim  1 , Yahya Mankong  3
Affiliations

Characteristics and outcomes of out-of-hospital cardiac arrest patients before and during the COVID-19 pandemic in Thailand

Phatthranit Phattharapornjaroen et al. Int J Emerg Med. .

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) remains one of the leading causes of death worldwide, and bystander CPR with public-access defibrillation improves OHCA survival outcomes. The COVID-19 pandemic has posed many challenges for emergency medical services (EMS), including the suggestion of compression-only resuscitation and recommendations for complete personal protective equipment, which have created operational difficulties and prolonged response time. However, the risk factors affecting OHCA outcomes during the pandemic are poorly defined. This study aimed to assess the characteristics and outcomes of OHCA patients before and during the COVID-19 pandemic in Thailand.

Methods: This single-center, retrospective cohort study used data from electronic medical records and EMS paper records. All OHCA patients who visited Ramathibodi Hospital's emergency department before COVID-19 (March 2018 to December 2019) and during COVID-19 (March 2020-December 2021) were identified, and the number of emergency department returns of spontaneous circulation (ED-ROSC) and characteristics in OHCA patients before and during the COVID-19 pandemic in Thailand were collected.

Results: A total of 136 patients were included (78 men [59.1%]; mean [SD] age, 67.9 [18] years); 60 of these were during the COVID-19 period (beginning March 2020), and 76 were before the COVID-19 period. The overall baseline characteristics that differed significantly between the two groups were bystander witness and mode of chest compression (p-values < 0.001 and < 0.001, respectively). The ED ROSC during the COVID-19 period was significantly lower than before the COVID-19 period (26.67% vs. 46.05%, adjusted OR 0.21, p-value < 0.001). There were significant differences in survival to admission between the COVID-19 period and before (25.00% and 40.79%, adjusted OR 0.26, p-value 0.005). However, 30-day survivals were not significantly different (3.3% during the COVID-19 period and 10.53% before the COVID-19 period).

Conclusions: During the COVID-19 pandemic in Thailand, ED ROSC and survival to admission in out-of-hospital cardiac arrest patients were significantly reduced. Additionally, the witness responses and mode of chest compression were very different between the two groups.

Trial registration: This trial was retrospectively registered on 7 December 2021 in the Thai Clinical Trial Registry, identification number TCTR20211207006.

Keywords: 30-day survival; COVID-19; Emergency department; Out-of-hospital cardiac arrest; Pandemic; Return of spontaneous circulation; SARS-CoV-2; Survival to admission.

PubMed Disclaimer

Conflict of interest statement

The authors report that there are no competing interests to declare.

Figures

Fig. 1
Fig. 1
illustrates the study protocol
See this image and copyright information in PMC

References

    1. Huang SK, Chen CY, Shih HM, Weng SJ, Liu SC, Huang FW, et al. Dispatcher-assisted cardiopulmonary resuscitation: Differential effects of landline, Mobile, and transferred calls. Resuscitation. 2020;1(146):96–102. doi: 10.1016/j.resuscitation.2019.11.008. - DOI - PubMed
    1. Kilner T, Stanton BL, Mazur SM. Prehospital extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: A retrospective eligibility study. Emerg Med Australas. 2019;31(6):1007–1013. doi: 10.1111/1742-6723.13317. - DOI - PubMed
    1. Gräsner JT, Herlitz J, Tjelmeland IBM, Wnent J, Masterson S, Lilja G, et al. European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe. Resuscitation. 2021;161:61–79. doi: 10.1016/j.resuscitation.2021.02.007. - DOI - PubMed
    1. Gräsner JT, Lefering R, Koster RW, Masterson S, Böttiger BW, Herlitz J, et al. EuReCa ONE-27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe. Resuscitation [Internet]. 2016 Aug 1 [cited 2022 Mar 4];105:188–95. Available from: https://www.sciencedirect.com/science/article/pii/S0300957216300995 - PubMed
    1. Hansen CM, Kragholm K, Pearson DA, Tyson C, Monk L, Myers B, et al. Association of bystander and first-responder intervention with survival after out-of-hospital cardiac arrest in North Carolina, 2010–2013. JAMA - Journal of the American Medical Association. 2015;314(3):255–264. doi: 10.1001/jama.2015.7938. - DOI - PubMed

LinkOut - more resources