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. 2023 Jun:187:109770.
doi: 10.1016/j.resuscitation.2023.109770. Epub 2023 Mar 17.

The effect of the COVID-19 pandemic on the incidence and survival outcomes of EMS-witnessed out-of-hospital cardiac arrest

Charlotte Kennedy  1 , Zainab Alqudah  2 , Dion Stub  3 , David Anderson  4 , Ziad Nehme  5
Affiliations

The effect of the COVID-19 pandemic on the incidence and survival outcomes of EMS-witnessed out-of-hospital cardiac arrest

Charlotte Kennedy et al. Resuscitation. 2023 Jun.

Abstract

Aim: We sought to examine the impact of the COVID-19 pandemic on the incidence and survival outcomes of emergency medical service (EMS)-witnessed out-of-hospital cardiac arrest (OHCA) in Victoria, Australia.

Methods: We performed an interrupted time-series analysis of adult EMS-witnessed OHCA patients of medical aetiology. Patients treated during the COVID-19 period (1st March 2020 to 31st December 2021) were compared to a historical comparator period (1st January 2012 and 28th February 2020). Multivariable poisson and logistic regression models were used to examine changes in incidence and survival outcomes during the COVID-19 pandemic, respectively.

Results: We included 5,034 patients, 3,976 (79.0%) in the comparator period and 1,058 (21.0%) in the COVID-19 period. Patients in the COVID-19 period had longer EMS response times, fewer public location arrests and were significantly more likely to receive mechanical CPR and laryngeal mask airways compared to the historical period (all p < 0.05). There were no significant differences in the incidence of EMS-witnessed OHCA between the comparator and COVID-19 periods (incidence rate ratio 1.06, 95% CI: 0.97-1.17, p = 0.19). Also, there was no difference in the risk-adjusted odds of survival to hospital discharge for EMS-witnessed OHCA occurring during COVID-19 period compared to the comparator period (adjusted odd ratio 1.02, 95% CI: 0.74-1.42; p = 0.90).

Conclusion: Unlike the reported findings in non-EMS-witnessed OHCA populations, changes during the COVID-19 pandemic did not influence incidence or survival outcomes in EMS-witnessed OHCA. This may suggest that changes in clinical practice that sought to limit the use of aerosol generating procedures did not influence outcomes in these patients.

Keywords: COVID-19; Emergency medical services; Incidence; Out of hospital cardiac arrest; Survival; Witness.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Incidence of all (EMS-attended) EMS-witnessed OHCA by month.
Fig. 2
Fig. 2
Monthly survival to hospital discharge for EMS-treated EMS-witnessed OHCA.
See this image and copyright information in PMC

Comment in

  • An unbroken ring of the chain of survival.
    Norii T, Igarashi Y. Norii T, et al. Resuscitation. 2023 Jun;187:109803. doi: 10.1016/j.resuscitation.2023.109803. Epub 2023 Apr 22. Resuscitation. 2023. PMID: 37088271 Free PMC article.

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