Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar: A nationwide observational study.
BACKGROUND
Out-of-hospital cardiac arrest (OHCA) studies from the Middle East and Asian region are limited. This study describes the epidemiology, emergency health services, and outcomes of OHCA in Qatar.


METHODS
This was a prospective nationwide population-based observational study on OHCA patients in Qatar according to Utstein style guidelines, from June 2012 to May 2013. Data was collected from various sources; the national emergency medical service, 4 emergency departments, and 8 public hospitals.


RESULTS
The annual crude incidence of presumed cardiac OHCA attended by EMS was 23.5 per 100,000. The age-sex standardized incidence was 87.8 per 100,000 population. Of the 447 OHCA patients included in the final analysis, most were male (n=360, 80.5%) with median age of 51years (IQR=39-66). Frequently observed nationalities were Qatari (n=89, 19.9%), Indian (n=74, 16.6%) and Nepalese (n=52, 11.6%). Bystander cardiopulmonary resuscitation (CPR) was carried out in 92 (20.6%) OHCA patients. Survival rate was 8.1% (n=36) and multivariable logistic regression indicated that initial shockable rhythm (OR 13.4, 95% CI 5.4-33.3, p=0.001) was associated with higher odds of survival while male gender (OR 0.27, 95% CI 0.1-0.8, p=0.01) and advanced cardiac life support (ACLS) (OR 0.15, 95% CI 0.04-0.5, p=0.02) were associated with lower odds of survival.


CONCLUSIONS
Standardized incidence and survival rates were comparable to Western countries. Although expatriates comprise more than 80% of the population, Qataris contributed 20% of the total cardiac arrests observed. There are significant opportunities to improve outcomes, including community-based CPR and defibrillation training.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83 Stockholm, Sweden; Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. Electronic address: furqan.irfan@gmail.com.
Furqan B
FB
Irfan
Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
Zain Ali
ZA
Bhutta
Helsinki University and Department of Emergency Medicine and Services, Helsinki University Hospital, Haartmaninkatu 4, 00029 HUS, Finland.
Maaret
M
Castren
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, VIC 3004, Australia.
Lahn
L
Straney
Department of Medicine Solna, 171 00, Karolinska Institutet, Sweden.
Therese
T
Djarv
Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA.
Tooba
T
Tariq
Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
Stephen Hodges
SH
Thomas
Hamad Medical Corporation Ambulance Service, Medical City, Doha, PO Box 3050, Qatar; School of Health and Social Work, Paramedic Division, University of Hertfordshire, Hatfield, AL10 9AB, HERTS, UK.
Guillaume
G
Alinier
Hamad Medical Corporation Ambulance Service, Medical City, Doha, PO Box 3050, Qatar.
Loua
L
Al Shaikh
Hamad Medical Corporation Ambulance Service, Medical City, Doha, PO Box 3050, Qatar.
Robert Campbell
RC
Owen
Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, PO Box 3050, Qatar.
Jassim
J
Al Suwaidi
Neuroscience Institute, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
Ashfaq
A
Shuaib
Cardiology Research, Heart Hospital, Hamad Medical Corporation, Doha, PO Box 3050, Qatar.
Rajvir
R
Singh
The Alfred Hospital, Emergency and Trauma Centre, School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, VIC 3004, Australia.
Peter Alistair
PA
Cameron
D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000379:methods / Q000458:organization & administration; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D011780:Qatar / Q000453:epidemiology; D015996:Survival Rate
Asia; Cardiac arrest; Cardiopulmonary resuscitation; Emergency Medical Services; Epidemiology; Middle East