Table 1.
Patient characteristics, prehospital data, and postresuscitation care data in the out-of-hospital cardiac arrest study population
| Total n = 1393 |
Prehospital ROSC n = 1285 (92%) |
Refractory OHCA n = 108 (8%) |
|
|---|---|---|---|
| Age, years (mean ± SD) | 65 ± 15 | 65 ± 11 | 61 ± 17 |
| Sex (male), n (%) | 961 (70%) | 882 (70%) | 79 (77%) |
| Cardiovascular comorbidity, n (%) | |||
| - Chronic ischemic heart disease | 289 (21%) | 265 (21%) | 24 (24%) |
| - Congestive heart failure | 215 (16%) | 203 (16%) | 12 (12%) |
| - Type 2 diabetes | 164 (12%) | 152 (12%) | 12 (12%) |
| - Hypertension | 494 (36%) | 460 (37%) | 34 (33%) |
| - Hypercholesterolemia | 252 (19%) | 233 (19%) | 19 (19%) |
| - Active smoking | 344 (25%) | 324 (26%) | 20 (20%) |
| High comorbidity burden (CCI ≥ 3)a, n (%) | 273 (20%) | 252 (20%) | 21 (21%) |
| OHCA circumstances | |||
| - Shockable primary rhythm, n (%) | 704 (52%) | 652 (52%) | 52 (50%) |
| - Publicb, n (%) | 496 (37%) | 443 (36%) | 53 (52%) |
| - Witnessed OHCA, n (%) | 1126 (86%) | 1040 (86%) | 86 (85%) |
| ◦ By EMSb | 70 (7%) | 58 (6%) | 12 (14%) |
| - Bystander CPR, n (%) | 704 (55%) | 649 (55%) | 55 (56%) |
| - Time to EMS (min), median (Q1-Q3) | 7 (5–9) | 6 (5–9) | 7 (5–10) |
| - Time to ROSC (min), median (Q1-Q3)b | 15 (9–23) | 15 (9–22) | 27 (20–41) |
| - Length of resuscitation attempt (min), median (Q1-Q3)b | 17 (10–29) | 16 (9–26) | 45 (27–68) |
| - Time to emergency room (min), median (Q1-Q3)b,c | 40 (31–52) | 40 (32–52) | 35 (25–47) |
| OHCA etiology | |||
| - Cardiovascular etiology, n (%) | 1100 (81%) | 1012 (81%) | 88 (87%) |
| ◦ STEMI, n (%) | 313 (28%) | 293 (29%) | 20 (23%) |
| ◦ NSTEMI, n (%) | 229 (21%) | 218 (22%) | 11 (13%) |
| ◦ Cardiogenic shock, n (%) | 63 (6%) | 54 (5%) | 9 (10%) |
| ◦ Primary arrhythmia, n (%) | 166 (15%) | 157 (16%) | 9 (10%) |
| ◦ Pulmonary embolism, n (%)b | 21 (2%) | 15 (1%) | 6 (7%) |
| ◦ Other cardiovascular etiology, n (%)b | 308 (28%) | 275 (27%) | 33 (38%) |
| Admitted to heart centerb | 836 (61%) | 763 (61%) | 73 (71%) |
| In-hospitald | |||
| - GCS > 9 after ROSC, n (%) | 127 (11%) | 123 (11%) | 4 (7%) |
| - Admitted ICU, n (%)b | 1085 (90%) | 1029 (89%) | 56 (100%) |
| - ICU days, median (Q1-Q3)b | 4 (2–7) | 4 (2–7) | 7 (4–9) |
| - Mechanical ventilation, n (%)b | 1085 (90%) | 1029 (89%) | 56 (100%) |
| - TTM, n (%) | 656 (55%) | 628 (56%) | 28 (51%) |
| - IABP, n (%)b | 48 (4%) | 40 (3%) | 8 (14%) |
| - EEG, n (%) | 217 (18%) | 203 (18%) | 14 (25%) |
| - CT cerebrum, n (%) | 435 (36%) | 414 (36%) | 21 (38%) |
| - Thrombolysis, n (%) | 9 (1%) | 8 (1%) | 1 (2%) |
| - CAG, n (%) | 500 (41%) | 480 (42%) | 20 (36%) |
| ◦ Early CAG (< 24 h) | 377 (31%) | 359 (31%) | 18 (32%) |
| - Revascularization (of patients with CAG) | |||
| ◦ PCI, n (%) | 269 (54%) | 259 (54%) | 10 (50%) |
| ◦ CABG, n (%) | 53 (11%) | 51 (11%) | 2 (10%) |
| - Temporary pacemaker, n (%) | 63 (5%) | 58 (5%) | 5 (9%) |
| - Permanent pacemaker/ICD, n (%) | 201 (17%) | 194 (17%) | 7 (13%) |
| Termination of in-hospital treatmentd,e | |||
| - Anoxic brain damage, n (%)b | 377 (50%) | 358 (52%) | 19 (25%) |
| - Circulatory failure, n (%)b | 292 (39%) | 239 (36%) | 53 (70%) |
| - Organ failure, n (%) | 81 (11%) | 77 (11%) | 4 (5%) |
| - Seizures, n (%)b | 56 (7%) | 56 (8%) | 0 (0%) |
| - High burden of comorbidities, n (%)b | 152 (20%) | 148 (22%) | 4 (5%) |
| - Time to ROSC, n (%)b | 35 (5%) | 25 (4%) | 10 (13%) |
| - Living will, n (%) | 9 (1%) | 9 (1%) | 0 (0%) |
| At hospital discharge | |||
| - LVEF > 35%, n (%) | 451 (55%) | 430 (55%) | 21 (51%) |
| - Favorable neurological outcome (CPC 1 or 2), n (%) | 456 (84) | 437 (84) | 19 (90) |
| - Nonfavorable neurological outcome (CPC 3 or 4), n (%) | 89 (16%) | 86 (16%) | 3 (14%) |
Abbreviations: CPR Cardiopulmonary resuscitation, ROSC Return of spontaneous circulation, OHCA Out of hospital cardiac arrest, EMS Emergency medical services, Q1-Q3 Interquartile range, STEMI ST elevation myocardial infarction, NSTEMI Non-ST elevation myocardial infarction, GCS Glasgow Coma Scale, ICU Intensive care unit, TTM Targeted temperature management, IABP Intra-aortic balloon pump, EEG Electroencephalography, CT Computed tomography, CAG Coronary angiography, PCI Percutaneous coronary intervention, CABG Coronary artery bypass grafting, ICD Implantable cardioverter defibrillator, LVEF Left ventricular ejection fraction, CPC Cerebral Performance Categories, CCI Charlson comorbidity index
All percentages are calculated after excluding missing data from the denominator
aCharlson comorbidity index (CCI), which is a validating index taking the severity of 22 conditions into account. CCI ≥ 3 was used as a marker of significant comorbidity [22]
bIndicates significant difference between patients with prehospital ROSC and refractory OHCA (p < 0.05)
cTime from emergency call to arrival in the emergency room
dPatients achieving and/or remaining in ROSC in the emergency department only
eMore than one reason may be listed per patient