Cardiac arrest in public locations--an independent predictor for better outcome?
OBJECTIVE
Outcome after cardiac arrest is known to be influenced by immediate access to resuscitation. We aimed to analyse the location of arrest in relation to the prognostic value for outcome.


METHODS
Retrospective review from prospective databases (ambulance routine documentation database and emergency department database on patients treated for cardiac arrest).


METHODS
Vienna (1.7 million inhabitants) ambulance service and tertiary care facility (university clinics).


METHODS
Two independent cohorts: (1) a population-based cohort of patients who were treated for cardiac arrest by the municipal ambulance service outside the hospital. The endpoint in this group was survival to hospital admission with spontaneous circulation. (2) A cohort of patients who were admitted to the emergency department after successful out of hospital resuscitation. The endpoint in this group was survival to 6 months with good neurological status (best Cerebral Performance Category 1 or 2 within 6 months).


METHODS
We analysed whether the location of non-traumatic adult out-of-hospital cardiac arrest (public versus private place) was a predictor for good outcome.


RESULTS
PATIENTS who had cardiac arrest in a public location were more likely to arrive in hospital alive (39% versus 31%, crude OR 1.4, 95% CI 1.001-1.975, p=0.049) and were more likely to have a good neurological outcome after 6 months (35% versus 25%, crude OR 1.65, adjusted OR 1.59, 95% CI 1.07-2.36, p=0.023), compared to patients who had cardiac arrest in a non-public location.


CONCLUSIONS
Cardiac arrest in a public location is independently associated with a better outcome.
Eisenburger
Philip
P
Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, A-1090 Vienna, Austria.
Sterz
Fritz
F
Haugk
Moritz
M
Scheinecker
Wolfdieter
W
Holzer
Michael
M
Koreny
Maria
M
Kaff
Alfred
A
Laggner
Anton
A
Herkner
Harald
H
D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D015331:Cohort Studies; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D016896:Treatment Outcome