Cardiac arrest in public locations—An independent predictor for better outcome?

• Published in: Resuscitation 2006-09, Vol.70 (3), p.395-403
• Main Authors: Eisenburger, Philip, Sterz, Fritz, Haugk, Moritz, Scheinecker, Wolfdieter, Holzer, Michael, Koreny, Maria, Kaff, Alfred, Laggner, Anton, Herkner, Harald
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Cohort Studies; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Emergency Medical Services; Female; Heart arrest; Heart Arrest - therapy; Humans; Intensive care medicine; Location; Long term outcome; Male; Medical sciences; Middle Aged; Odds Ratio; Out-of-hospital; Prognosis; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Treatment Outcome
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2006.02.002

Outcome after cardiac arrest is known to be influenced by immediate access to resuscitation. We aimed to analyse the location of arrest in relation to the prognostic value for outcome. Retrospective review from prospective databases (ambulance routine documentation database and emergency department database on patients treated for cardiac arrest). Setting: Vienna (1.7 million inhabitants) ambulance service and tertiary care facility (university clinics). Patients: Two independent cohorts: (1) a population-based cohort of patients who were treated for cardiac arrest by the municipal ambulance service outside the hospital. The endpoint in this group was survival to hospital admission with spontaneous circulation. (2) A cohort of patients who were admitted to the emergency department after successful out of hospital resuscitation. The endpoint in this group was survival to 6 months with good neurological status (best Cerebral Performance Category 1 or 2 within 6 months). We analysed whether the location of non-traumatic adult out-of-hospital cardiac arrest (public versus private place) was a predictor for good outcome. Patients who had cardiac arrest in a public location were more likely to arrive in hospital alive (39% versus 31%, crude OR 1.4, 95% CI 1.001–1.975, p = 0.049) and were more likely to have a good neurological outcome after 6 months (35% versus 25%, crude OR 1.65, adjusted OR 1.59, 95% CI 1.07–2.36, p = 0.023), compared to patients who had cardiac arrest in a non-public location. Cardiac arrest in a public location is independently associated with a better outcome.