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  • Out-of-hospital cardiac arrest attended by ambulance services in Ireland: first 2 years’ results from a nationwide registry

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Original article
Out-of-hospital cardiac arrest attended by ambulance services in Ireland: first 2 years’ results from a nationwide registry
  1. Siobhán Masterson1,
  2. John Cullinan2,
  3. Bryan McNally3,
  4. Conor Deasy4,5,
  5. Andrew Murphy1,
  6. Peter Wright7,
  7. Martin O'Reilly8,
  8. Akke Vellinga6
  1. 1Discipline of General Practice, National University of Ireland Galway, Galway, Ireland
  2. 2School of Business and Economics, National University of Ireland Galway, Galway, Ireland
  3. 3School of Medicine, Emory University, Atlanta, USA
  4. 4Medical Directorate, National Ambulance Service, Naas, Ireland
  5. 5Department of Emergency Medicine, Cork University Hospital, Cork, Ireland
  6. 6School of Medicine, National University of Ireland Galway, Galway, Ireland
  7. 7Department of Public Health Medicine, Health Service Executive, Ballyshannon, Ireland
  8. 8EMS Support Unit, Dublin Fire Brigade, Dublin, Ireland
  1. Correspondence to Siobhán Masterson, Discipline of General Practice, National University of Ireland Galway, Distillery Road, Newcastle, Galway, Ireland; siobhan.masterson{at}nuigalway.ie

Abstract

Background National data collection provides information on out-of-hospital cardiac arrest (OHCA) incidence, management and outcomes that may not be generalisable from smaller studies. This retrospective cohort study describes the first 2 years' results from the Irish National Out-of-Hospital Cardiac Arrest Register (OHCAR).

Methods Data on OHCAs attended by emergency medical services (EMS) where resuscitation was attempted (EMS-treated) were collected from ambulance services and entered onto OHCAR. Descriptive analysis of the study population was performed, and regression analysis was performed on the subgroup of adult patients with a bystander-witnessed event of presumed cardiac aetiology and an initial shockable rhythm (Utstein group).

Results 3701 EMS-treated OHCAs were recorded for the study period (1 January 2012–31 December 2013). Incidence was 39/100 000 population/year. In the Utstein group (n=577), compared with the overall group, there was a higher proportion of male patients, public event location, bystander cardiopulmonary resuscitation (CPR) and early defibrillation. Median EMS call–response interval was similar in both groups. A higher proportion of patients in the Utstein group achieved return of spontaneous circulation (35% vs 17%) and survival to hospital discharge (22% vs 6%). After multivariate adjustment for the Utstein group, the following variables were found to be independent predictors of the outcome survival to hospital discharge: public event location (OR 3.1 (95% CI 1.9 to 5.0)); bystander CPR (2.4 (95% CI 1.2 to 4.9)); EMS response of 8 min or less (2.2 (95% CI 1.3 to 3.6)).

Conclusions This study highlights the role of nationwide registries in quantifying, monitoring and benchmarking OHCA incidence and outcome, providing baseline data upon which service improvement effects can be measured.

  • prehospital care
  • resuscitation
  • cardiac arrest

https://doi.org/10.1136/emermed-2015-205107

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    Footnotes

    • Contributors SM: performed data analysis and drafted the text of the manuscript. JC: co-supervised. SM: wrote, read and reviewed manuscript drafts. CD: contributed to the introduction and discussion text. MO: contributed to the methods section. PW: contributed to the discussion section. AM: contributed to the discussion and conclusion sections. BM: reviewed text and advised on data analysis. AV: co-supervised. SM: drafted the text, contributed to manuscript text, instructed on data analysis plan and checked results.

    • Funding SM is funded by the Health Professionals Fellowship Award from the Health Research Board, Ireland (HPF-2014-609).

    • Competing interests BM reports grants from American Red Cross, the American Heart Association, Medtronic Philanthropy and Zoll Corporation, outside the submitted work.

    • Ethics approval Research Ethics Committee, NUI Galway.

    • Provenance and peer review Not commissioned; externally peer reviewed.