title: Outcomes for out-of-hospital cardiac arrests across 7 countries in Asia: The Pan Asian Resuscitation Outcomes Study (PAROS).
abstract: BACKGROUND
  The Pan Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network (CRN) was established in collaboration with emergency medical services (EMS) agencies and academic centers in Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and UAE-Dubai and aims to report out-of-hospital cardiac arrests (OHCA) and provide a better understanding of OHCA trends in Asia.
  
  
  RESULTS
  This is a prospective, international, multi-center cohort study of OHCA across the Asia-Pacific. Each participating country provided between 1.5 and 2.5 years of data from January 2009 to December 2012. All OHCA cases conveyed by EMS or presenting at emergency departments were captured. 66,780 OHCA cases were submitted to the PAROS CRN; 41,004 cases were presumed cardiac etiology. The mean age OHCA occurred varied from 49.7 to 71.7 years. The proportion of males ranged from 57.9% to 82.7%. Proportion of unwitnessed arrests ranged from 26.4% to 67.9%. Presenting shockable rhythm rates ranged from 4.1% to 19.8%. Bystander cardiopulmonary resuscitation (CPR) rates varied from 10.5% to 40.9%, however <1.0% of these arrests received bystander defibrillation. For arrests that were with cardiac etiology, witnessed arrest and VF, the survival rate to hospital discharge varied from no reported survivors to 31.2%. Overall survival to hospital discharge varied from 0.5% to 8.5%. Survival with good neurological function ranged from 1.6% to 3%.
  
  
  CONCLUSIONS
  Survival to hospital discharge for Asia varies widely and this may be related to patient and system differences. This implies that survival may be improved with interventions such as increasing bystander CPR, public access defibrillation and improving EMS.
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore; Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, Singapore. Electronic address: marcus.ong.e.h@sgh.com.sg.
authors.forename: Marcus Eng Hock
authors.initials: ME
authors.lastname: Ong
authors.affiliation: Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Shin
authors.affiliation: Singapore Clinical Research Institute Pte Ltd, Singapore, Singapore; Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Nurun Nisa Amatullah
authors.initials: NN
authors.lastname: De Souza
authors.affiliation: Department of EMS System, Graduate School, Kokushikan University, Tokyo, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Acute Medicine, Kindai University Faculty of Medicine, Osaka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nishiuchi
authors.affiliation: Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
authors.forename: Kyoung Jun
authors.initials: KJ
authors.lastname: Song
authors.affiliation: Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Patrick Chow-In
authors.initials: PC
authors.lastname: Ko
authors.affiliation: Emergency Medicine Department, National University Hospital, Singapore, Singapore.
authors.forename: Benjamin Sieu-Hon
authors.initials: BS
authors.lastname: Leong
authors.affiliation: Department of Emergency Medicine, Rajavithi Hospital, Bangkok, Thailand.
authors.forename: Nalinas
authors.initials: N
authors.lastname: Khunkhlai
authors.affiliation: Department of Health & Medical Services, ED-Trauma Centre, Rashid Hospital, Dubai, United Arab Emirates.
authors.forename: Ghulam Yasin
authors.initials: GY
authors.lastname: Naroo
authors.affiliation: Department of Emergency Medicine, Hospital Sungai Buloh, Sungai Buloh, Selangor, Malaysia.
authors.forename: Abdul Karim
authors.initials: AK
authors.lastname: Sarah
authors.affiliation: Medical Department, Singapore Civil Defence Force, Singapore, Singapore.
authors.forename: Yih Yng
authors.initials: YY
authors.lastname: Ng
authors.affiliation: Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Wen Yun
authors.initials: WY
authors.lastname: Li
authors.affiliation: Department of Emergency Medicine, National Taiwan University, Taipei, Taiwan, ROC.
authors.forename: Matthew Huei-Ming
authors.initials: MH
authors.lastname: Ma
mesh_terms: D000368:Aged; D001208:Asia / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends
keywords: Asia-Pacific; Out-of-hospital cardiac arrest; Registry