title: Cardiac arrest due to drowning--changes over time and factors of importance for survival.
abstract: OBJECTIVE
  To evaluate changes in characteristics and survival over time in out-of-hospital cardiac arrest (OHCA) due to drowning and describe factors of importance for survival.
  
  
  METHODS
  Retrospectively reported and treated drowning cases reported to the Swedish OHCA registry between 1990 and 2012, n=529. The data were clustered into three seven-year intervals for comparisons of changes over time.
  
  
  RESULTS
  There were no changes in age, gender, witnessed status, shockable rhythm or place of OHCA during the time periods. Bystander CPR increased over time, 59% in interval 1992-1998, versus 74% in interval 2006-2012 (p=0.005). There was a decrease in delay between OHCA and calling for the Emergency Medical Service (EMS) over the years, while calling for the EMS to arrival increased in terms of time. Survival to hospital admission appears to have increased over the years (p=0.009), whereas survival to one month did not change significantly over time. In a multivariate analysis, witnessed status, female gender, bystander CPR, place-home and EMS response time were associated with survival to hospital admission. For survival to one month, place, age, shockable rhythm and logarithmised delay from calling for an ambulance to arrival were of significance for survival.
  
  
  CONCLUSIONS
  In OHCA due to drowning, over a period of 20 years, bystanders have called for help at an earlier stage and administered CPR more frequently in the past few years. Survival to hospital admission has increased, while shockable rhythm and early arrival of the EMS appear to be the most important factors for survival to one month.
authors.affiliation: Kungälv Ambulance Service, SE-442 40 Kungälv, Sweden; Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden; Centre for Pre-hospital Research, Western Sweden, Prehospen, University College of Borås and Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: andreas.claesson@telia.com.
authors.forename: Andreas
authors.initials: A
authors.lastname: Claesson
authors.affiliation: Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
authors.forename: Jonny
authors.initials: J
authors.lastname: Lindqvist
authors.affiliation: Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden; Centre for Pre-hospital Research, Western Sweden, Prehospen, University College of Borås and Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015701:Near Drowning; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
keywords: CPR; Drowning; Guidelines; OHCA; Survival