Improved survival after an out-of-hospital cardiac arrest using new guidelines.
BACKGROUND
An out-of-hospital cardiac arrest (OHCA) is associated with a poor prognosis. We hypothesized that the implementations of 2005 European Resuscitation Council resuscitation guidelines were associated with improved 30-day survival after OHCA.


METHODS
We prospectively recorded data on all patients with OHCA treated by the Mobile Emergency Care Unit of Copenhagen in two periods: 1 June 2004 until 31 August 2005 (before implementation) and 1 January 2006 until 31 March 2007 (after implementation), separated by a 4-month period in which the above-mentioned change took place.


RESULTS
We found that 30-day survival increased after the implementation from 31/372 (8.3%) to 67/419 (16%), P=0.001. ROSC at hospital admission, as well as survival to hospital discharge, were obtained in a significantly higher proportion from 23.4% to 39.1%, P<0.0001, and from 7.9% to 16.3%, P=0.0004, respectively. Treatment after implementation was confirmed as a significant predictor of better 30-day survival in a logistic regression analysis.


CONCLUSIONS
The implementation of new resuscitation guidelines was associated with improved 30-day survival after OHCA.
Steinmetz
J
J
Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. jacobsteinmetz@dadlnet.dk
Barnung
S
S
Nielsen
S L
SL
Risom
M
M
Rasmussen
L S
LS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000706:statistics & numerical data*; D003718:Denmark; D004632:Emergency Medical Services / Q000379:methods* / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D017408:Guidelines as Topic; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D014693:Ventricular Fibrillation / Q000628:therapy