Immediate and 1-year survival of out-of-hospital cardiac arrest victims in southern New Jersey: 1995-2000.
Most studies report the out-of-hospital cardiac arrest (OHCA) survival to hospital discharge. One-year survival and neurological outcomes in southern New Jersey in 1996-2000 were analyzed using a retrospective data review. There were 1,597 cases of OHCA. Initial survival ranged between 15% in 2000 and 19% in 1997. Survival to hospital discharge, taken as a percent of the initial survivors, decreased from 44% in 1997 to 22% in 2000. In relation to all OHCA victims, survival to discharge decreased from 7.2% to 2.4%, respectively. On discharge from the hospital 19-50% of people had the diagnosis of anoxic brain damage. In ventricular fibrillation, survival to discharge was 41%, 46.7%, 40.7%, 37.5%, and 17.4%, respectively, from 1996 to 2000. The response time increased from 6.6 to 8.1 minutes. Correlation coefficient between in-hospital survival and response time was -0.73. The percent of people discharged with neurological damage increased from 38% to 50%. Initial survival was 29.2% in shockable and 7.5% in nonshockable rhythm (P < 0.001). Survival to discharge was 11.3% versus 1.6%, and survival to 1 year was 9.6% versus 0.7%, respectively (P < 0.001 for all). Overall, the neurologically favorable 1-year survival rate was 2.3% of all OHCA victims. One-year survival of OHCA victims without neurological deficits is low. In southern New Jersey the survival rate did not improve over the 5-year study. Not only initial (prehospital) mortality, but also "delayed" (in-hospital mortality) increases with increase of response time.
Guglin
Maya E
ME
Cooper Hospital/UMDNJ, Camden, New Jersey, USA. meguglin@prodigy.net
Wilson
Alan
A
Kostis
John B
JB
Parrillo
Joseph E
JE
White
Melvin C
MC
Gessman
Lawrence J
LJ
D001925:Brain Damage, Chronic / Q000401:mortality; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000401:mortality*; D006801:Humans; D008297:Male; D009515:New Jersey / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate; D014693:Ventricular Fibrillation / Q000401:mortality