European registry of cardiac arrest study THREE (EuReCa- THREE) - EMS response time influence on outcome in Europe

Abstract

Background: Throughout Europe there are important differences in the structure and characteristics of Emergency Medical Services (EMS) and their response to out-of-hospital cardiac arrest (OHCA). The primary aim of EuReCa-THREE was to examine the epidemiology of cardiac arrest in Europe and explore the association between EMS response time and survival.

Methods: EuReCa-THREE was an international, prospective, registry-based, cohort study, for which data were collected from 1 September to 30 November 2022 from 28 countries. Primary research questions were focused on assessing time intervals and their impact on outcomes.

Results: Of the 45,251 confirmed OHCA cases, 32,033 were treated by the EMS i.e. resuscitation started or continued. The mean response time was 12.2 min (range 6.4-22.8), with 25% of patients were reached within 7 min. For all cases where resuscitation was started or continued by EMS, the rate of any ROSC was 31.2% (range 17.0-42.7), ROSC sustained until arrival at the emergency department and transfer of care (survived event) was 22.5%(range 12.3-25.5) and overall survival was 7.5% (range 3.1-35.0), (incidence 4.0 per 100,000 inhabitants, range 1.7-24.6).

Conclusion: The results of EuReCa-THREE highlight continuing variation in the incidence, management and outcomes from OHCA across Europe. For patients who were EMS-treated, results indicate clear associations between response times and the likelihood of survival.

Keywords: Epidemiology; EuReCa; Out-of-hospital cardiac arrest; Response time; Resuscitation; Survival; Time intervals.