title: Out-of-hospital cardiac arrest attended by ambulance services in Ireland: first 2 years' results from a nationwide registry.
abstract: BACKGROUND
  National data collection provides information on out-of-hospital cardiac arrest (OHCA) incidence, management and outcomes that may not be generalisable from smaller studies. This retrospective cohort study describes the first 2 years' results from the Irish National Out-of-Hospital Cardiac Arrest Register (OHCAR).
  
  
  METHODS
  Data on OHCAs attended by emergency medical services (EMS) where resuscitation was attempted (EMS-treated) were collected from ambulance services and entered onto OHCAR. Descriptive analysis of the study population was performed, and regression analysis was performed on the subgroup of adult patients with a bystander-witnessed event of presumed cardiac aetiology and an initial shockable rhythm (Utstein group).
  
  
  RESULTS
  3701 EMS-treated OHCAs were recorded for the study period (1 January 2012-31 December 2013). Incidence was 39/100 000 population/year. In the Utstein group (n=577), compared with the overall group, there was a higher proportion of male patients, public event location, bystander cardiopulmonary resuscitation (CPR) and early defibrillation. Median EMS call-response interval was similar in both groups. A higher proportion of patients in the Utstein group achieved return of spontaneous circulation (35% vs 17%) and survival to hospital discharge (22% vs 6%). After multivariate adjustment for the Utstein group, the following variables were found to be independent predictors of the outcome survival to hospital discharge: public event location (OR 3.1 (95% CI 1.9 to 5.0)); bystander CPR (2.4 (95% CI 1.2 to 4.9)); EMS response of 8 min or less (2.2 (95% CI 1.3 to 3.6)).
  
  
  CONCLUSIONS
  This study highlights the role of nationwide registries in quantifying, monitoring and benchmarking OHCA incidence and outcome, providing baseline data upon which service improvement effects can be measured.
authors.affiliation: Discipline of General Practice, National University of Ireland Galway, Galway, Ireland.
authors.forename: Siobhán
authors.initials: S
authors.lastname: Masterson
authors.affiliation: School of Business and Economics, National University of Ireland Galway, Galway, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Cullinan
authors.affiliation: School of Medicine, Emory University, Atlanta, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: McNally
authors.affiliation: Medical Directorate, National Ambulance Service, Naas, Ireland.|Department of Emergency Medicine, Cork University Hospital, Cork, Ireland.
authors.forename: Conor
authors.initials: C
authors.lastname: Deasy
authors.affiliation: Discipline of General Practice, National University of Ireland Galway, Galway, Ireland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Murphy
authors.affiliation: Department of Public Health Medicine, Health Service Executive, Ballyshannon, Ireland.
authors.forename: Peter
authors.initials: P
authors.lastname: Wright
authors.affiliation: EMS Support Unit, Dublin Fire Brigade, Dublin, Ireland.
authors.forename: Martin
authors.initials: M
authors.lastname: O'Reilly
authors.affiliation: School of Medicine, National University of Ireland Galway, Galway, Ireland.
authors.forename: Akke
authors.initials: A
authors.lastname: Vellinga
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000592:standards* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007494:Ireland; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality*; D063868:Patient Outcome Assessment; D012042:Registries / Q000706:statistics & numerical data; D012044:Regression Analysis; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: cardiac arrest; prehospital care; resuscitation