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Out-of-hospital cardiac arrests: an 8-year New York City experience
R E Westfal1, S Reissman, G Doering
1Department of Emergency Medicine, St. Vincent's Hospital and Medical Center of New York, NY 10011, USA.
Insights
Survival rates for out-of-hospital cardiac arrests in New York City were poor. Witnessed ventricular fibrillation arrests showed slightly better outcomes, but overall survival remained low for these emergency medical services events.
Area of Science:
- Emergency Medicine
- Cardiology
- Public Health
Background:
- Out-of-hospital cardiac arrest (OHCA) presents a significant public health challenge.
- Prehospital emergency medical services (EMS) play a critical role in initial resuscitation efforts.
- Understanding OHCA outcomes is vital for improving survival rates.
Purpose of the Study:
- To evaluate the survival outcomes of OHCA patients treated by a specific prehospital system in New York City.
- To analyze factors influencing survival, such as witnessed arrests and initial cardiac rhythm.
- To provide data consistent with the Utstein Style for standardized reporting.
Main Methods:
- Retrospective analysis of OHCA cases from January 1986 to December 1993.
- Inclusion of data from a single prehospital system in New York City.
- Application of Utstein Style guidelines for data recording and reporting.
Main Results:
- Overall survival rate for 382 patients who arrested before EMS arrival was 2.1% (8/382).
- For witnessed arrests in ventricular fibrillation (96/246), survival was 7.3% (7/96); 71.4% had good neurological function.
- Patients arrested in the presence of EMS had a 12.5% survival rate (3/24).
Conclusions:
- The study confirms a generally poor survival rate for OHCA in New York City during the study period.
- Witnessed cardiac arrests, particularly in ventricular fibrillation, offered a better prognosis.
- Improvements in prehospital care and public awareness are crucial for enhancing OHCA survival.
Abstract:
A retrospective study was conducted to determine the outcome of out-of-hospital cardiac arrests by one prehospital system in New York City from January, 1986, through December, 1993. The results were recorded consistent with the Utstein Style. Of 481 attempted patient resuscitations 406 were of cardiac etiology, with 382 patients having arrested prior to EMS arrival; their overall survival rate was 2.1% (8/382). Cardiac arrests were witnessed in 246 patients. Of the witnessed arrest patients found in ventricular fibrillation (96/246), the overall survival rate was 7.3% (7/96). Of the 7 survivors who were discharged from the hospital, 71.4% (5/7) had a good cerebral performance/good overall performance. Of 24 patients who arrested in the presence of EMS, the survival rate was 12.5% (3/24). This study confirms a poor survival rate for patients suffering out-of-hospital cardiac arrests in New York City.