TY - JOUR
T1 - Out-of-hospital cardiac arrest without return of spontaneous circulation in the field
T2 - Who are the survivors?
AU - Xiong, Yan
AU - Zhan, Hong
AU - Lu, Yuanzheng
AU - Guan, Kaipan
AU - Liao, Xiaoxing
AU - Leatham, Auna
AU - Salazar, Gilberto
AU - Idris, Ahamed
N1 - Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background Return of spontaneous circulation (ROSC) in the field is a vital determinant contributing to survival from out-of-hospital cardiac arrest (OHCA). However, nearly one third of survivors at the Dallas-Fort Worth (DFW) Resuscitation Outcomes Consortium (ROC) site did not obtain ROSC in the field. Methods A retrospective, observational analysis was performed on all adult patients with non-traumatic OHCA treated on scene and transported to hospital, who did not gain ROSC in the field at DFW ROC site between 2006 through 2011.We described the demographics, pre-hospital characteristics and outcomes of all enrolled cases. Those patients without ROSC in the field, who did and did not meet Termination of Resuscitation (TOR) criteria in the field, were also compared. Results Among a total of 5099 treated and transported non-traumatic OHCA cases, 83.2% (4243) were included in this study as patients without ROSC gained in the field, of which 66.6% (2827) met TOR criteria but still were treated and transported; 1.9% (79) survived to hospital discharge. Further analysis showed that 39.2% (31) of survivors met TOR rule, accounting for 1.1% of those patients who should have been declared dead in the field. Shockable initial rhythms, EMS-witnessed arrest, bystander CPR and age were factors significant to predict survival from OHCA without ROSC in the field. Of concern, 1.7% (47) of patients who met TOR presented initially shockable rhythms but no shocks were delivered in the field. Conclusions We suggest that all treated non-traumatic OHCA patients should be transported to hospital.
AB - Background Return of spontaneous circulation (ROSC) in the field is a vital determinant contributing to survival from out-of-hospital cardiac arrest (OHCA). However, nearly one third of survivors at the Dallas-Fort Worth (DFW) Resuscitation Outcomes Consortium (ROC) site did not obtain ROSC in the field. Methods A retrospective, observational analysis was performed on all adult patients with non-traumatic OHCA treated on scene and transported to hospital, who did not gain ROSC in the field at DFW ROC site between 2006 through 2011.We described the demographics, pre-hospital characteristics and outcomes of all enrolled cases. Those patients without ROSC in the field, who did and did not meet Termination of Resuscitation (TOR) criteria in the field, were also compared. Results Among a total of 5099 treated and transported non-traumatic OHCA cases, 83.2% (4243) were included in this study as patients without ROSC gained in the field, of which 66.6% (2827) met TOR criteria but still were treated and transported; 1.9% (79) survived to hospital discharge. Further analysis showed that 39.2% (31) of survivors met TOR rule, accounting for 1.1% of those patients who should have been declared dead in the field. Shockable initial rhythms, EMS-witnessed arrest, bystander CPR and age were factors significant to predict survival from OHCA without ROSC in the field. Of concern, 1.7% (47) of patients who met TOR presented initially shockable rhythms but no shocks were delivered in the field. Conclusions We suggest that all treated non-traumatic OHCA patients should be transported to hospital.
KW - Cardiac arrest
KW - Outcomes
KW - Return of spontaneous circulation
KW - Termination of Resuscitation
UR - http://www.scopus.com/inward/record.url?scp=85007566464&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85007566464&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2016.12.013
DO - 10.1016/j.resuscitation.2016.12.013
M3 - Article
C2 - 28012882
AN - SCOPUS:85007566464
SN - 0300-9572
VL - 112
SP - 28
EP - 33
JO - Resuscitation
JF - Resuscitation
ER -