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BMC Emergency Medicine
Published in: BMC Emergency Medicine 1/2023

Open Access 01-12-2023 | Airway Management | Research

Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study

Authors: Jae Yun Ahn, Hyun Wook Ryoo, Sungbae Moon, Haewon Jung, Jungbae Park, Won Kee Lee, Jong-yeon Kim, Dong Eun Lee, Jung Ho Kim, Sang-Hun Lee

Published in: BMC Emergency Medicine | Issue 1/2023

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Abstract

Background

Prehospital factors play a vital role in out-of-hospital cardiac arrest (OHCA) survivability, and they vary between countries and regions. We investigated the prehospital factors associated with OHCA outcomes in a single metropolitan city in the Republic of Korea.

Methods

This study included adult medical OHCA patients enrolled prospectively, using data from the citywide OHCA registry for patients registered between 2018 and 2021. The primary outcome was survival to hospital discharge. Multivariable logistic regression analysis was conducted to determine the factors associated with the study population’s clinical outcomes, adjusting for covariates. We performed a sensitivity analysis for clinical outcomes only for patients without prehospital return of spontaneous circulation prior to emergency medical service departure from the scene.

Results

In multivariable logistic regression analysis, older age (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.95–0.97), endotracheal intubation (adjusted odds ratio [aOR] 0.29; 95% [CIs] 0.17–0.51), supraglottic airway (aOR 0.29; 95% CI 0.17–0.51), prehospital mechanical chest compression device use (OR 0.13; 95% CI 0.08–0.18), and longer scene time interval (OR 0.96; 95% CI 0.93–1.00) were negatively associated with survival. Shockable rhythm (OR 24.54; 95% CI 12.99–42.00), pulseless electrical activity (OR 3.11; 95% CI 1.74–5.67), and witnessed cardiac arrest (OR 1.59; 95% CI 1.07–2.38) were positively associated with survival. In the sensitivity analysis, endotracheal intubation, supraglottic airway, prehospital mechanical chest compression device use, and longer scene time intervals were associated with significantly lower survival to hospital discharge.

Conclusions

Regional resuscitation protocol should be revised based on the results of this study, and modifiable prehospital factors associated with lower survival of OHCA should be improved.
Appendix
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Metadata
Title
Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study
Authors
Jae Yun Ahn
Hyun Wook Ryoo
Sungbae Moon
Haewon Jung
Jungbae Park
Won Kee Lee
Jong-yeon Kim
Dong Eun Lee
Jung Ho Kim
Sang-Hun Lee
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Emergency Medicine / Issue 1/2023
Electronic ISSN: 1471-227X
DOI
https://doi.org/10.1186/s12873-023-00899-3

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