title: Long-term survival following out-of-hospital cardiac arrest.
abstract: Although the factors associated with short-term survival from out-of-hospital cardiac arrest (OHCA) are well established, relatively little is known about the factors that influence long-term survival. In this study, we describe the 15-year survival outcomes of OHCA survivors and examine the influence of peri-arrest factors and 12-month outcomes on long-term survival.
  
  
  
  Survivors of OHCA between 2000 and 2014 identified from the Victorian Ambulance Cardiac Arrest Registry were linked with state-wide death records. Kaplan-Meier survival curves and Cox regression models were used to estimate long-term survival outcomes.
  
  
  
  A total of 3449 patients were included with a mean survival duration of 11.9 (95% CI 11.7 to 12.1) years. The 1-year survival rate was 92.2% (95% CI 91.3% to 93.1%), while the 5, 10 and 15-year survival rates were 81.4% (95% CI 79.9% to 82.8%), 70.1% (95% CI 67.9% to 72.1%) and 62.3% (95% CI 58.9% to 65.5%), respectively. The standardised mortality rate of OHCA survivors was 5.6 times that of the standard Australian population in the first-year postarrest, but approached that of the standard population 5 years postarrest. Few peri-arrest factors were independently associated with long-term survival after discharge. Rather, transport to a percutaneous coronary intervention-capable hospital and discharge home from hospital were associated with longevity. Returning to work and favourable physical/functional recovery were associated with improved survival after 12 months.
  
  
  
  OHCA survivors experience relatively favourable long-term survival after discharge from hospital. While peri-arrest factors had little influence on long-term survival after hospital discharge, favourable recovery postdischarge was associated with improved long-term outcomes.
authors.affiliation: Department of Research and Evaluation, Ambulance Victoria, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Emily
authors.initials: E
authors.lastname: Andrew
authors.affiliation: Department of Research and Evaluation, Ambulance Victoria, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.|Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Australia.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Nehme
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
authors.forename: Rory
authors.initials: R
authors.lastname: Wolfe
authors.affiliation: Department of Research and Evaluation, Ambulance Victoria, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.|Intensive Care Unit, Alfred Hospital, Melbourne, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bernard
authors.affiliation: Department of Research and Evaluation, Ambulance Victoria, Melbourne, Australia.|Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.|Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Australia.|School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality*; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D017741:Survivors / Q000706:statistics & numerical data*; D014739:Victoria / Q000453:epidemiology
keywords: Cardiac arrest; Cardiac arrhythmias and resuscitation science; Epidemiology; Quality and outcomes of care