title: High survival rate of 43% in out-of-hospital cardiac arrest patients in an optimised chain of survival.
abstract: OBJECTIVE
  Survival to hospital discharge after out-of-hospital cardiac arrest (OHCA) varies widely. This study describes short-term survival after OHCA in a region with an extensive care path and a follow-up of 1 year.
  
  
  METHODS
  Consecutive patients ≥16 years admitted to the emergency department between April 2011 and December 2012 were included. In July 2014 a follow-up took place. Socio-demographic data, characteristics of the OHCA and interventions were described and associations with survival were determined.
  
  
  RESULTS
  Two hundred forty-two patients were included (73 % male, median age 65 years). In 76 % the cardiac arrest was of cardiac origin and 52 % had a shockable rhythm. In 74 % the cardiac arrest was witnessed, 76 % received bystander cardiopulmonary resuscitation and in 39 % an automatic external defibrillator (AED) was used. Of the 168 hospitalised patients, 144 underwent therapeutic procedures. A total of 105 patients survived until hospital discharge. Younger age, cardiac arrest in public area, witnessed cardiac arrest, cardiac origin with a shockable rhythm, the use of an AED, shorter time until return of spontaneous circulation, Glasgow Coma Scale (GCS) ≥13 during transport and longer length of hospital stay were associated with survival. Of the 105 survivors 72 survived for at least 1 year after cardiac arrest and 6 patients died.
  
  
  CONCLUSIONS
  A survival rate of 43 % after OHCA is achievable. Witnessed cardiac arrest, cardiac cause of arrest, initial cardiac rhythm and GCS ≥13 were associated with higher survival.
authors.affiliation: Rijnlands Rehabilitation Centre, Wassenaarseweg 501, 2333AL, Leiden, the Netherlands, lww@rrc.nl.
authors.forename: L W
authors.initials: LW
authors.lastname: Boyce
authors.forename: T P M
authors.initials: TP
authors.lastname: Vliet Vlieland
authors.forename: J
authors.initials: J
authors.lastname: Bosch
authors.forename: R
authors.initials: R
authors.lastname: Wolterbeek
authors.forename: G
authors.initials: G
authors.lastname: Volker
authors.forename: H J
authors.initials: HJ
authors.lastname: van Exel
authors.forename: C
authors.initials: C
authors.lastname: Heringhaus
authors.forename: M J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: P H
authors.initials: PH
authors.lastname: Goossens