One-year survival after prehospital cardiac arrest: the Utstein style applied to a rural-suburban system.
To evaluate the recently published Utstein algorithm (Ann Emerg Med 1991;20:861), the authors conducted a retrospective review of all advanced life support (ALS) trip sheets and hospital records of patients with prehospital cardiac arrests between January 1988 and December 1989. Telephone follow-up was used to determine 1-year survival rates. Of 713 arrests in the 24-month study period, 601 were of presumed cardiac etiology. Approximately 599 of these charts were available for analysis. One hundred ninety-three (32.2%) of these had return of spontaneous circulation (ROSC), 36 (6.0%) survived to hospital discharge, and 24 were alive at 1-year follow-up (4.0% of total or 67% of survivors to discharge). The Utstein style was found to be a useful algorithmic format for reporting prehospital cardiac arrest data in a manner that should allow direct comparison between emergency medical service (EMS) systems. Existing prehospital record-keeping practices (trip sheets) are easily adapted to this style of data collection, although certain data for the template (eg, resuscitations not attempted and alive at 1-year) are more difficult to ascertain. Additionally, the authors report their own experience during a 2-year period, including data that suggest that the majority of patients with cardiac arrest who survive to hospital discharge are still alive at 1 year.
Kass
L E
LE
Department of Emergency Medicine, York Hospital, PA.
Eitel
D R
DR
Sabulsky
N K
NK
Ogden
C S
CS
Hess
D R
DR
Peters
K L
KL
D000465:Algorithms; D016887:Cardiopulmonary Resuscitation; D003625:Data Collection / Q000592:standards; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy; D006801:Humans; D011996:Records / Q000592:standards*; D012189:Retrospective Studies; D012424:Rural Population; D013383:Suburban Population; D016019:Survival Analysis