title: Epidemiology and outcomes in out-of-hospital cardiac arrest: a report from the NEDIS-based cardiac arrest registry in Korea.
abstract: Sudden cardiac death (SCD) is a significant issue affecting national health policies. The National Emergency Department Information System for Cardiac Arrest (NEDIS-CA) consortium managed a prospective registry of out-of-hospital cardiac arrest (OHCA) at the emergency department (ED) level. We analyzed the NEDIS-CA data from 29 participating hospitals from January 2008 to July 2009. The primary outcomes were incidence of OHCA and final survival outcomes at discharge. Factors influencing survival outcomes were assessed as secondary outcomes. The implementation of advanced emergency management (drugs, endotracheal intubation) and post-cardiac arrest care (therapeutic hypothermia, coronary intervention) was also investigated. A total of 4,156 resuscitation-attempted OHCAs were included, of which 401 (9.6%) patients survived to discharge and 79 (1.9%) were discharged with good neurologic outcomes. During the study period, there were 1,662,470 ED visits in participant hospitals; therefore, the estimated number of resuscitation-attempted CAs was 1 per 400 ED visits (0.25%). Factors improving survival outcomes included younger age, witnessed collapse, onset in a public place, a shockable rhythm in the pre-hospital setting, and applied advanced resuscitation care. We found that active advanced multidisciplinary resuscitation efforts influenced improvement in the survival rate. Resuscitation by public witnesses improved the short-term outcomes (return of spontaneous circulation, survival admission) but did not increase the survival to discharge rate. Strategies are required to reinforce the chain of survival and high-quality cardiopulmonary resuscitation in Korea.
authors.affiliation: The ACLS Committee of the Korean Association of Cardiopulmonary Resuscitation, Seoul, Korea. ; Department of Emergency Medicine, Gachon University Gill Hospital, Incheon, Korea.
authors.forename: Hyuk Jun
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: The ACLS Committee of the Korean Association of Cardiopulmonary Resuscitation, Seoul, Korea. ; Department of Emergency Medicine, School of Medicine, Ajou University, Suwon, Korea.
authors.forename: Gi Woon
authors.initials: GW
authors.lastname: Kim
authors.affiliation: The ACLS Committee of the Korean Association of Cardiopulmonary Resuscitation, Seoul, Korea. ; Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, Gachon University Gill Hospital, Incheon, Korea.
authors.forename: Jin Seong
authors.initials: JS
authors.lastname: Cho
authors.affiliation: The ACLS Committee of the Korean Association of Cardiopulmonary Resuscitation, Seoul, Korea. ; Division of Cardiology, Department of Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Tai Ho
authors.initials: TH
authors.lastname: Rho
authors.affiliation: National Emergency Medical Center, Seoul, Korea.
authors.forename: Han Deok
authors.initials: HD
authors.lastname: Yoon
authors.affiliation: The ACLS Committee of the Korean Association of Cardiopulmonary Resuscitation, Seoul, Korea. ; Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
authors.forename: Mi Jin
authors.identifier: 0000-0002-3773-8047
authors.initials: MJ
authors.lastname: Lee
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000401:mortality*; D003422:Critical Care / Q000706:statistics & numerical data*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D004554:Electric Countershock / Q000401:mortality; D004632:Emergency Medical Services; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology* / Q000401:mortality* / Q000628:therapy; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Cardiac Rhythms; Death, Sudden, Cardiac; Emergency Department; Outcome; Resuscitation