Non-traumatic out-of-hospital cardiac arrest in rural Taiwan: A retrospective study

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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.

Design:

A retrospective observational study.

Setting:

All seven designated community hospital emergency departments (ED) in Nantou County, Taiwan.

Participants:

All OHCA patients from May 2011 to March 2013.

Main outcome measures:

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.

Conclusion:

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.

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