title: Characteristics and outcomes of young adults who suffered an out-of-hospital cardiac arrest (OHCA).
abstract: There is paucity of data examining the incidence and outcomes of young OHCA adults. The aim of this study is to determine the outcomes and characteristics of young adults who suffered an OHCA and identify factors that are associated with favourable neurologic outcomes.
  
  
  
  All EMS-attended OHCA adults between the ages of 16 and 35 years in the Pan-Asian Resuscitation Outcomes Study (PAROS) registry were analysed. The primary outcome was favourable neurologic outcome (Cerebral Performance Category 1 or 2) at hospital discharge or at 30th day post OHCA if not discharged. Regression analysis was performed to identify factors associated with favourable neurologic outcomes.
  
  
  
  66,780 OHCAs were collected between January 2009 and December 2013; 3244 young OHCAs had resuscitation attempted by emergency medical services (EMS). 56.8% of patients had unwitnessed arrest; 47.9% were of traumatic etiology. 17.2% of patients (95% CI: 15.9-18.5%) had return of spontaneous circulation; 7.8% (95% CI: 6.9-8.8%) survived to one month; 4.6% (95% CI: 4.0-5.4%) survived with favourable neurologic outcomes. Factors associated with favourable neurologic outcomes include witnessed arrest (adjusted RR=2.42, p-value<0.0001), bystander CPR (adjusted RR=1.57, p-value=0.004), first arrest shockable rhythm (adjusted RR=27.24, p-value<0.0001), and cardiac etiology (adjusted RR=3.99, p-value<0.0001).
  
  
  
  OHCA among young adults are not uncommon. Traumatic OHCA, occurring most frequently in young adults had dismal prognosis. First arrest rhythms of VF/VT/unknown shockable rhythm, cardiac etiology, bystander-witnessed arrest, and bystander CPR were associated with favourable neurological outcomes. The results of the study would be useful for planning preventive and interventional strategies, improving EMS, and guiding future research.
authors.affiliation: Emergency Department, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. Electronic address: Michael_Yc_Chia@ttsh.com.sg.
authors.forename: Michael Yih-Chong
authors.initials: MY
authors.lastname: Chia
authors.affiliation: Singapore Clinical Research Institute Pte Ltd., 31 Biopolis Way, Nanos #02-01, Singapore 138669, Singapore.
authors.forename: Qing Shu
authors.initials: QS
authors.lastname: Lu
authors.affiliation: Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia.
authors.forename: Nik Hisamuddin
authors.initials: NH
authors.lastname: Rahman
authors.affiliation: Emergency Department, Sengkang Health, 378 Alexandra Road, Singapore 159964, Singapore.
authors.forename: Nausheen Edwin
authors.initials: NE
authors.lastname: Doctor
authors.affiliation: Department of Acute Medicine, Kindai University Faculty of Medicine, 3-4-1 Kowakae, Higashiosaka City, Osaka 577-8502, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nishiuchi
authors.affiliation: Emergency Medicine Department, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
authors.forename: Benjamin Sieu-Hon
authors.initials: BS
authors.lastname: Leong
authors.affiliation: Department of Emergency Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore.
authors.forename: Lai Peng
authors.initials: LP
authors.lastname: Tham
authors.affiliation: Emergency Medicine, Raffles Medical Group, 585 North Bridge Road, Singapore 188770, Singapore.
authors.forename: E-Shaun
authors.initials: ES
authors.lastname: Goh
authors.affiliation: Accident and Emergency Department, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore.
authors.forename: Ling
authors.initials: L
authors.lastname: Tiah
authors.affiliation: Emergency Medicine Unit, Faculty of Internal Medicine, Siriraj Hospital, Bangkoknoi, Bangkok 10700, Thailand.
authors.forename: Apichaya
authors.initials: A
authors.lastname: Monsomboon
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, Outram Road, Singapore 169608, Singapore; Health Services and Systems Research, Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857, Singapore.
authors.forename: Marcus Eng Hock
authors.initials: ME
authors.lastname: Ong
mesh_terms: D000293:Adolescent; D000328:Adult; D024201:Bystander Effect; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000209:etiology / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D011379:Prognosis; D012042:Registries; D012151:Resuscitation; D016896:Treatment Outcome
keywords: Cardiopulmonary resuscitation; Favourable neurologic outcomes; Out-of-hospital cardiac arrests; Prognosis young adults; Return of spontaneous circulation; Ventricular fibrillation