title: Survival and Neurologic Outcome After Out-of-hospital Cardiac Arrest. Results of the Andalusian Out-of-hospital Cardiopulmonary Arrest Registry.
abstract: OBJECTIVE
  There is a paucity of data on prehospital cardiac arrest in Spain. Our aim was to describe the incidence, patient characteristics, and outcomes of out-of-hospital emergency care for this event.
  
  
  METHODS
  We conducted a retrospective analysis of a prospective registry of cardiopulmonary arrest handled by an out-of-hospital emergency service between January 2008 and December 2012. The registry included all patients considered to have a cardiac etiology as the cause of arrest, with a descriptive analysis performed of general patient characteristics and factors associated with good neurologic outcome at hospital discharge.
  
  
  RESULTS
  A total of 4072 patients were included, with an estimated incidence of 14.6 events per 100000 inhabitants and year; 72.6% were men. The mean age was 62.0 ± 15.8 years, 58.6% of cases occurred in the home, 25% of patients had initial defibrillable rhythm, 28.8% of patients arrived with a pulse at the hospital (58.3% of the group with defibrillable rhythm), and 10.2% were discharged with good neurologic outcome. The variables associated with this recovery were: witnessed arrest (P=.04), arrest witnessed by emergency team (P=.005), previous life support (P=.04), initial defibrillable rhythm (P=.0001), and performance of a coronary interventional procedure (P=.0001).
  
  
  CONCLUSIONS
  More than half the cases of sudden cardiac arrest occur at home, and the population was found to be relatively young. Although recovery was satisfactory in 1 out of every 10 patients, there is a need for improvement in the phase prior to emergency team arrival. Coronary interventional procedures had an impact on patient prognosis.
authors.affiliation: Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain. Electronic address: frosell@al.epes.es.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rosell Ortiz
authors.affiliation: Servicio de Urgencias, Hospital El Toyo, Retamar, Almería, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Mellado Vergel
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Río Carrión, Palencia, Spain.
authors.forename: Juan Bautista
authors.initials: JB
authors.lastname: López Messa
authors.affiliation: Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Fernández Valle
authors.affiliation: Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain.
authors.forename: María M
authors.initials: MM
authors.lastname: Ruiz Montero
authors.affiliation: Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain.
authors.forename: Manuela
authors.initials: M
authors.lastname: Martínez Lara
authors.affiliation: Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Vergara Pérez
authors.affiliation: Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain.
authors.forename: Itziar
authors.initials: I
authors.lastname: Vivar Díaz
authors.affiliation: Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain.
authors.forename: Auxiliadora
authors.initials: A
authors.lastname: Caballero García
authors.affiliation: Unidad de Cuidados Intensivos, Hospital Clínico Virgen de La Victoria, Málaga, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: García Alcántara
authors.affiliation: Empresa Pública de Emergencias Sanitarias de Andalucía, Consejería de Salud, Junta de Andalucía, Sevilla, Spain; Grupo de Cuidados Cardiológicos en Emergencias, Empresa Pública de Emergencias Sanitarias de Andalucía, Málaga, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: García Del Águila
mesh_terms: D000293:Adolescent; D000328:Adult; D022561:Advanced Cardiac Life Support; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D004554:Electric Countershock; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology / Q000503:physiopathology*; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D061665:Time-to-Treatment; D016896:Treatment Outcome; D055815:Young Adult
keywords: Emergency services; Estado neurológico; Muerte súbita cardiaca; Neurologic outcome; Out-of-hospital cardiopulmonary arrest; Parada cardiorrespiratoria extrahospitalaria; Servicios de emergencias; Sudden cardiac death; Supervivencia; Survival