title: Regional variation and outcome of out-of-hospital cardiac arrest (ohca) in Finland - the Finnresusci study.
abstract: BACKGROUND
  Despite the efforts of the modern Emergency Medical Service Systems (EMS), survival rates for sudden out-of-hospital cardiac arrest (OHCA) have been poor as approximately 10% of OHCA patients survive hospital discharge. Many aspects of OHCA have been studied, but few previous reports on OHCA have documented the variation between different sizes of study areas on a regional scale. The aim of this study was to report the incidence, outcomes and regional variation of OHCA in the Finnish population.
  
  
  METHODS
  From March 1st to August 31st, 2010, data on all OHCA patients in the southern, central and eastern parts of Finland was collected. Data collection was initiated via dispatch centres whenever there was a suspected OHCA case or if a patient developed OHCA before arriving at the hospital. The study area includes 49% of the Finnish population; they are served by eight dispatch centres, two university hospitals and six central hospitals.
  
  
  RESULTS
  The study period included 1042 cases of OHCA. Resuscitation was attempted on 671 patients (64.4%), an incidence of 51/100,000 inhabitants/year. The initial rhythm was shockable for 211 patients (31.4%). The survival rate at one-year post-OHCA was 13.4%. Of the witnessed OHCA events with a shockable rhythm of presumed cardiac origin (n=140), 64 patients (45.7%) were alive at hospital discharge and 47 (33.6%) were still living one year hence. Surviving until hospital admission was more likely if the OHCA occurred in an urban municipality (41.5%, p=0.001).
  
  
  CONCLUSIONS
  The results of this comprehensive regional study of OHCA in Finland seem comparable to those previously reported in other countries. The survival of witnessed OHCA events with shockable initial rhythms has improved in urban Finland in recent decades.
authors.affiliation: Department of Prehospital Emergency Care, Emergency and Intensive Care, Kuopio University Hospital, Kuopio, Finland. pamela.hiltunen@kuh.fi
authors.forename: Pamela
authors.initials: P
authors.lastname: Hiltunen
authors.forename: Markku
authors.initials: M
authors.lastname: Kuisma
authors.forename: Tom
authors.initials: T
authors.lastname: Silfvast
authors.forename: Juha
authors.initials: J
authors.lastname: Rutanen
authors.forename: Jukka
authors.initials: J
authors.lastname: Vaahersalo
authors.forename: Jouni
authors.initials: J
authors.lastname: Kurola
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D016009:Chi-Square Distribution; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D005387:Finland; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D015996:Survival Rate