The location of collapse and its effect on survival from cardiac arrest

Survival from cardiac arrest is higher when the collapse occurs outside the home. Of 781 patients collapsing at home, 101 (13%) survived to hospital discharge. This compared with 66 survivors among 248 (27%) patients arresting outside the home (P less than .001). Patients collapsing outside the home were younger and more frequently were men. Cardiac arrests outside the home were more often witnessed, more likely to have bystander CPR, less often preceded by symptoms, and the collapsing rhythm was more frequently ventricular fibrillation. Mean time to CPR was shorter. Multivariate logistic regression showed that the effect of location on survival was still statistically significant, although diminished, after adjusting for the above variables (P less than .01). We speculate that comorbidity, underlying etiology, and activity level may explain the remaining difference. Because 76% of arrests occur in the home, efforts to increase the frequency of bystander-CPR through targeted and dispatcher-assisted CPR programs are warranted.