title: Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies.
abstract: OBJECTIVE
  The aim of this investigation was to estimate and contrast the global incidence and outcome of out-of-hospital cardiac arrest (OHCA) to provide a better understanding of the variability in risk and survival of OHCA.
  
  
  METHODS
  We conducted a review of published English-language articles about incidence of OHCA, available through MEDLINE and EmBase. For studies including adult patients and both adult and paediatric patients, we used Utstein data reporting guidelines to calculate, summarize and compare incidences per 100,000 person-years of attended OHCAs, treated OHCAs, treated OHCAs with a cardiac cause, treated OHCA with ventricular fibrillation (VF), and survival-to-hospital discharge rates following OHCA.
  
  
  RESULTS
  Sixty-seven studies from Europe, North America, Asia or Australia met inclusion criteria. The weighted incidence estimate was significantly higher in studies including adults than in those including adults and paediatrics for treated OHCAs (62.3 vs 34.7; P<0.001); and for treated OHCAs with a cardiac cause (54.6 vs 40.8; P=0.004). Neither survival to discharge rates nor VF survival to discharge rates differed statistically significant among studies. The incidence of treated OHCAs was higher in North America (54.6) than in Europe (35.0), Asia (28.3), and Australia (44.0) (P<0.001). In Asia, the percentage of VF and survival to discharge rates were lower (11% and 2%, respectively) than those in Europe (35% and 9%, respectively), North America (28% and 6%, respectively), or Australia (40% and 11%, respectively) (P<0.001, P<0.001).
  
  
  CONCLUSIONS
  OHCA incidence and outcome varies greatly around the globe. A better understanding of the variability is fundamental to improving OHCA prevention and resuscitation.
authors.affiliation: Department of Cardiology, Academic Medical Centre - University of Amsterdam, Amsterdam, The Netherlands. J.Berdowski@amc.nl
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Berdowski
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Rudolph W
authors.initials: RW
authors.lastname: Koster
mesh_terms: D016887:Cardiopulmonary Resuscitation; D004632:Emergency Medical Services / Q000379:methods*; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014693:Ventricular Fibrillation / Q000401:mortality / Q000628:therapy