Prediction of survival after out-of-hospital cardiac arrest: results of a community-based study in Vienna.
The objective of this study was the assessment of out-of-hospital cardiac arrest and the definition of possible predictive factors for final hospital discharge. Out of a database of 89,557 consecutive missions of the Vienna emergency medical system (EMS) during 1990, there were 623 missions due to a collapse of non-traumatic origin: in 374 cases (60.0%) the patients were declared dead without further attempts at resuscitation. The remaining 249 patients were analysed for predictive factors at site. Survival to hospital admission: 109 patients survived to hospital admission (43.7%); bystander support had a small impact (P < 0.05) on survival to hospital arrival whereas age and gender had no predictive power. Most patients with ventricular tachycardia/fibrillation (VT/VF) survived primarily (69 of 117, i.e. 59.0%). Survival to hospital discharge: 27 patients were discharged from hospital care (10.8%). ECG findings on arrival of the EMS physician at the site proved to be the only powerful predictor for survival: 24 of 117 patients with VT/VF survived compared with only one of 81 with primary asystole, two of 39 with severe bradycardia, and no patient with electromechanical dissociation.
Gaul
G B
GB
Department of Cardiology, Hanuschkrankenhaus, Wiener Gebietskrankenkasse, Vienna, Austria.
Gruska
M
M
Titscher
G
G
Blazek
G
G
Havelec
L
L
Marktl
W
W
Muellner
W
W
Kaff
A
A
D001317:Austria; D001919:Bradycardia / Q000175:diagnosis; D016887:Cardiopulmonary Resuscitation; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D008297:Male; D010351:Patient Discharge; D016019:Survival Analysis