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Out-of-hospital cardiac arrest in Hong Kong: a territory-wide study
K L Fan1, L P Leung2, Y C Siu3
1Accident and Emergency Department, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Insights
Survival rates for out-of-hospital cardiac arrest in Hong Kong are low. Implementing public access defibrillation and CPR training could improve outcomes for cardiac arrest patients.
Area of Science:
- Emergency medicine
- Public health
- Cardiology
Background:
- Out-of-hospital cardiac arrest (OHCA) presents a significant global health challenge.
- Hong Kong experiences the impact of OHCA events, necessitating local epidemiological data.
- This study provides the first territory-wide analysis of OHCA in Hong Kong.
Purpose of the Study:
- To investigate the epidemiology and outcomes of out-of-hospital cardiac arrest in Hong Kong.
- To identify factors influencing survival rates for OHCA patients.
- To inform strategies for improving patient survival and neurological outcomes.
Main Methods:
- Retrospective analysis of prospectively collected emergency medical service data (August 2012 - July 2013).
- Descriptive statistics were used to report patient and cardiac arrest characteristics, emergency response times, and survival rates.
- Logistic regression was employed to identify predictors of 30-day survival.
Main Results:
- Analyzed 5154 cases of OHCA; median patient age was 80 years; most arrests occurred at home.
- Median emergency response time was 9 minutes; median time to first defibrillation was 12 minutes.
- 30-day survival was 2.3%, with 1.5% achieving good neurological outcome. Arrest location, initial rhythm, and defibrillation time predicted survival.
Conclusions:
- The survival rate for OHCA patients in Hong Kong is critically low.
- Public access defibrillation programs and widespread cardiopulmonary resuscitation (CPR) training are recommended.
- These interventions have the potential to significantly improve OHCA survival rates in the region.
Introduction:
Out-of-hospital cardiac arrest is a global health care problem. Like other cities in the world, Hong Kong faces the impact of such events. This study is the first territory-wide investigation of the epidemiology and outcomes of out-of-hospital cardiac arrest in Hong Kong. It is hoped that the findings can improve survival of patients with cardiac arrest.
Methods:
This study was a retrospective analysis of the prospectively collected data on out-of-hospital cardiac arrest managed by the emergency medical service from 1 August 2012 to 31 July 2013. The characteristics of patients and cardiac arrests, timeliness of emergency medical service attendance, and survival rates were reported with descriptive statistics. Predictors of 30-day survival were evaluated with logistic regression.
Results:
A total of 5154 cases of out-of-hospital cardiac arrest were analysed. The median age of patients was 80 years. Most arrests occurred at the patient's home. Ventricular fibrillation or ventricular tachycardia was identified in 8.7% of patients. The median time taken for the emergency services to reach the patient was 9 minutes. The median time to first defibrillation was 12 minutes. Of note, 2.3% of patients were alive at 30 days or survived to hospital discharge; 1.5% had a good neurological outcome. Location of arrest, initial electrocardiogram rhythm, and time to first defibrillation were independent predictors of survival at 30 days.
Conclusion:
The survival rate of out-of-hospital cardiac arrest patients in Hong Kong is low. Territory-wide public access defibrillation programme and cardiopulmonary resuscitation training may help improve survival.
