European registry of cardiac arrest study THREE (EuReCa- THREE) - EMS response time influence on outcome in Europe

Throughout Europe there are important differences in the structure and characteristics of Emergency Medical Services (EMS) and their response to out-of-hospital cardiac arrest (OHCA). The primary aim of EuReCa-THREE was to examine the epidemiology of cardiac arrest in Europe and explore the association between EMS response time and survival.

EuReCa-THREE was an international, prospective, registry-based, cohort study, for which data were collected from 1 September to 30 November 2022 from 28 countries. Primary research questions were focused on assessing time intervals and their impact on outcomes.

Of the 45,251 confirmed OHCA cases, 32,033 were treated by the EMS i.e. resuscitation started or continued. The mean response time was 12.2 min (range 6.4-22.8), with 25% of patients were reached within 7 min. For all cases where resuscitation was started or continued by EMS, the rate of any ROSC was 31.2% (range 17.0-42.7), ROSC sustained until arrival at the emergency department and transfer of care (survived event) was 22.5%(range 12.3-25.5) and overall survival was 7.5% (range 3.1-35.0), (incidence 4.0 per 100,000 inhabitants, range 1.7-24.6).

The results of EuReCa-THREE highlight continuing variation in the incidence, management and outcomes from OHCA across Europe. For patients who were EMS-treated, results indicate clear associations between response times and the likelihood of survival.