Factors associated with an increased chance of survival among patients suffering from an out-of-hospital cardiac arrest in a national perspective in Sweden

• Published in: The American heart journal Vol. 149; no. 1; pp. 61 - 66
• Main Authors: Herlitz, Johan, Engdahl, Johan, Svensson, Leif, Ängquist, Karl-Axel, Young, Marie, Holmberg, Stig
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 2005; Elsevier; Elsevier Limited
• Subjects: Age; Age Factors; Aged; Biological and medical sciences; Cardiac and Cardiovascular Systems; Cardiology. Vascular system; Cardiopulmonary Resuscitation; Clinical Medicine; CPR; Drug overdose; Emergency Medical Services; Female; Heart Arrest - mortality; Heart Arrest - therapy; Heart Arrest/mortality/therapy; Heart attacks; Hospitalization; Humans; Kardiologi; Klinisk medicin; Male; MEDICAL AND HEALTH SCIENCES; Medical sciences; MEDICIN OCH HÄLSOVETENSKAP; Middle Aged; Multivariate analysis; Sex Factors; Statistical methods; Survival Analysis; Sweden - epidemiology; Time Factors; Ventricular Fibrillation - complications; Sweden; Europe; Human; Cardiocirculatory arrest; Perspective; Association; Prognosis; Heart disease; Cardiovascular disease; Hospital; Survival
• ISSN: 0002-8703; 1097-6744; 1097-6744
• DOI: 10.1016/j.ahj.2004.07.014

To describe factors associated with an increased chance of survival among patients suffering from an out-of-hospital cardiac arrest in Sweden. All patients suffering from an out-of-hospital cardiac arrest, which were not crew witnessed, in Sweden and in whom cardiopulmonary resuscitation (CPR) was attempted and who were registered in the Swedish Cardiac Arrest Registry. This registry covers about 85% of the Swedish population and has been running since 1990. In all, 33 453 patients, 71% of whom had a cardiac etiology, were included in the survey. The following were independent predictors for an increased chance of survival in order of magnitude: (1) patients found in ventricular fibrillation (odds ratio [OR] 5.3, 95% confidence limits [CL] 4.2-6.8), (2) the interval between call for and arrival of the ambulance less than or equal to the median (OR 3.6, 95% CL 2.9-4.6), (3) cardiac arrest occurred outside the home (OR 2.2, 95% CL 1.9-2.7), (4) cardiac arrest was witnessed (OR 2.0, 95% CL 1.6-2.7), (5) bystanders performing CPR before the arrival of the ambulance (OR 2.0, 95% CL 1.7-2.4), and (6) age less than or equal to the median (OR 1.6, 95% CL 1.4-2.0). When none of these factors were present, survival to 1 m was 0.4%; when all factors were present, survival was 23.8%. Among patients suffering from an out-of-hospital cardiac arrest, which were not crew witnessed, in Sweden and in whom CPR was attempted, 6 factors for an increased chance of survival could be defined. These include (1) initial rhythm, (2) delay to arrival of the rescue team, (3) place of arrest, (4) witnessed status, (5) bystander CPR, and (6) age.