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Out-of-hospital cardiac arrest survival improving over time: Results from the Resuscitation Outcomes Consortium (ROC)

Mohamud R Daya1, Robert H Schmicker2, Dana M Zive1

  • 1Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, United States.

Resuscitation
|February 14, 2015
PubMed

Insights

Survival rates for out-of-hospital cardiac arrest (OHCA) improved significantly between 2006 and 2010. This study analyzed OHCA cases, showing better outcomes due to updated resuscitation guidelines.

Area of Science:

  • Emergency medicine
  • Cardiology
  • Public health

Background:

  • Out-of-hospital cardiac arrest (OHCA) is a major cause of death, with previous studies showing stagnant survival rates.
  • Evolving resuscitation guidelines emphasize CPR quality, minimized interruptions, and standardized post-resuscitation care.
  • The Resuscitation Outcomes Consortium (ROC) cardiac arrest registry (Epistry) and randomized clinical trials (RCTs) provide data for outcome evaluation.

Purpose of the Study:

  • To evaluate temporal trends in OHCA survival rates.
  • To assess if OHCA outcomes have improved among EMS agencies participating in ROC registries and RCTs.
  • To analyze survival improvements in specific subgroups, such as those with initial pulseless ventricular tachycardia or ventricular fibrillation (VT/VF).

Main Methods:

  • An observational cohort study analyzed 47,148 EMS-treated OHCA cases from the Epistry registry (2006-2010).
  • Data included patient, scene, and event characteristics, alongside EMS-treated OHCA outcomes over time.
  • Subgroup analysis focused on cases with initial VT/VF rhythm.

Main Results:

  • Unadjusted survival to discharge for treated OHCA increased from 8.2% (2006) to 10.4% (2010).
  • Survival rates for VT/VF subgroups also significantly increased: VT/VF from 21.4% to 29.3%, and bystander-witnessed VT/VF from 23.5% to 30.3%.
  • Adjusted survival to discharge in 2010 was significantly higher compared to 2006 across all analyzed groups (p < 0.001).

Conclusions:

  • ROC-wide survival rates for OHCA demonstrated a significant increase between 2006 and 2010.
  • These findings suggest improvements in OHCA care and outcomes during this period.
  • Further research is needed to pinpoint the specific factors driving this observed survival improvement.
Abstract

Keywords:
Emergency Medical Services (EMS)Out-of-hospital cardiac arrest (OHCA)Resucitation

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