title: Non-traumatic out-of-hospital cardiac arrest in rural Taiwan: A retrospective study.
abstract: OBJECTIVE
  Out-of-hospital cardiac arrest (OHCA) studies are usually conducted at metropolitan medical centres. Because rural studies are rare, our study aimed to assess non-traumatic OHCA prevalence and resuscitation outcomes in rural Taiwan.
  
  
  METHODS
  A retrospective observational study.
  
  
  METHODS
  All seven designated community hospital emergency departments (ED) in Nantou County, Taiwan.
  
  
  METHODS
  All OHCA patients from May 2011 to March 2013.
  
  
  METHODS
  Any return of spontaneous circulation (ROSC) and survival for ED discharge.
  
  
  RESULTS
  In the 23-month period, 850 OHCA cases were reported; 741 (87.2%) were non-traumatic. The overall ROSC achievement rate was 19.7%, with 16.4% case survival for ED discharge. Logistic regression identified that arrest in public (OR: 2.62, 95% CI: 1.19-5.78), witness when collapsed (OR: 2.14, 95% CI: 1.28-3.60), and cardiopulmonary resuscitation (CPR) by bystander (OR: 2.09, 95% CI: 1.02-4.26) might increase the likelihood of any ROSC; arrest in public (OR: 2.68, 95% CI: 1.10-6.50), witnessed collapse (OR: 2.26, 95% CI: 1.24-4.09) and CPR by bystander (OR: 2.79, 95% CI: 1.28-6.05) might also increase the likelihood of survival. For non-traumatic OHCA patients conveyed to EDs via emergency medical service system (EMS), a shorter response time (OR: 1.09, 95% CI: 1.01-1.18) and travelling time (OR: 1.04, 95% CI: 1.00-1.09) might also increase the chance of survival.
  
  
  CONCLUSIONS
  Compared to previous data from metropolitan areas, ROSC achievement rate was lower in rural Taiwan. Witness presence, response and travelling times affect ROSC achievement in non-traumatic OHCA patients in rural Taiwan.
authors.affiliation: Department of Emergency Medicine, Nantou Hospital, Nantou, Taiwan.|Department of Health Care Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
authors.forename: Shih-Chang
authors.initials: SC
authors.lastname: Hung
authors.affiliation: Department of Emergency Medicine, Nantou Hospital, Nantou, Taiwan.|National Environmental Health Research Center, National Health Research Institutes, Miaoli, Taiwan.
authors.forename: Ching-Yi
authors.initials: CY
authors.lastname: Mou
authors.affiliation: Department of Health Care Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.|Department of Internal Medicine, Nantou Hospital, Nantou, Taiwan.
authors.forename: Hung-Chang
authors.initials: HC
authors.lastname: Hung
authors.affiliation: College of Medicine, China Medical University, Taichung, Taiwan.|Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Lai
authors.affiliation: Department of Emergency Medicine, Chu Shang Show Chwan Hospital, Nantou, Taiwan.
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Chen
authors.affiliation: Department of Emergency Medicine, Puli Christian Hospital, Nantou, Taiwan.
authors.forename: Jui-Wen
authors.initials: JW
authors.lastname: Lin
authors.affiliation: Department of Emergency Medicine, Yumin Hospital, Nantou, Taiwan.
authors.forename: Ssu-Hung
authors.initials: SH
authors.lastname: Wang
authors.affiliation: Department of Emergency Medicine, Nantou Christian Hospital, Nantou, Taiwan.
authors.forename: Chung-Kuang
authors.initials: CK
authors.lastname: Chen
authors.affiliation: Department of Emergency Medicine, Taichung Veterans General Hospital Puli branch, Nantou, Taiwan.
authors.forename: Kai-Chun
authors.initials: KC
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D019035:Rural Health Services / Q000706:statistics & numerical data*; D013624:Taiwan / Q000453:epidemiology
keywords: 
  OHCA
  ; community; emergency medical service; pre-hospital; time