Original articleFactors Associated With Mortality in Out-of-hospital Cardiac Arrests Attended in Basic Life Support Units in the Basque Country (Spain)Factores asociados a la mortalidad extrahospitalaria de las paradas cardiorrespiratorias atendidas por unidades de soporte vital básico en el País Vasco
Section snippets
INTRODUCTION
Out-of-hospital cardiopulmonary arrest (OHCA) is an important health problem because the probability of recovery is small even though the process is potentially reversible.
The exact incidence of this condition in Spain is still not known. National estimates range from 10 0001 to 50 000 events per year.2 This lack of data is due to the lack of a specific central registry and of national studies on OHCA, to the methodological limitations of the available studies, and to differences in the
METHODS
The study sample comprised all cases of OHCA between July 1, 2009 and December 31, 2010 in which CPR was initiated by a BLSU of the emergency health transport system of the Basque Country with semiautomatic external defibrillators at their disposal (either as the only resource available or in combination with an ALSU).
The data were taken from the central OHCA database maintained by Emergentziak-Osakidetza. Entries to this database are made using the clinical information collected with a
RESULTS
During the 18 months of the study period, 1272 OHCA events with resuscitation attempts were recorded in the database; in 1050 (82.5%) of these, a basic life support resource was deployed. Case details and general characteristics are shown in Figure 1. The remaining cases (222) were attended exclusively by advanced life support resources and so were excluded from this study.
CPR outside the hospital measures were successful in 15.7% of the interventions, and the patients were transferred to
DISCUSSION
Based on the consideration that the data source for OHCA used for this study considers all resuscitations performed by emergency health resources in the Basque Country, the ratio of OHCA cases of any etiology attended during the study period (1272) and the resident population in this autonomous community, it is possible to calculate an approximate incidence of 3.9 (95%CI, 3.6-4.2) events per 10 000 inhabitants or 18 400 cases per year if the data were extrapolated to the entire Spanish population.
CONCLUSIONS
The findings of this study show that the chances of surviving CRA in the Basque Country are low and that CPR is very seldom attempted prior to arrival of the ambulance. A shockable rhythm, age<65 years, early initiation of life support measures, and occurrence at a site outside the home were associated with increased survival until transfer to hospital.
In addition, the findings of the present study highlight the need to strive to create strategies aimed at reducing EMS response time and
CONFLICTS OF INTEREST
None declared.
Acknowledgments
We thank all members of the basic life support resources in the network of emergency transport of the Basque Country (Red Cross, DYA [Detente y Ayuda], Transporte Sanitario Bizkaia, Ambulancias Euskadi, Larrialdiak, Gipuzkoa Emergentziak and Ambulancias Gipuzkoa) for their cooperation in collecting and sending the data, and to Emergentziak Osakidetza for providing us with access.
References (26)
Supervivencia de la parada cardíaca
Rev Clin Esp
(2002)- et al.
The effect of experience of on-site physicians on survival from prehospital cardiac arrest
Resuscitation
(1996) - et al.
Resuscitation cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. A statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation
Resuscitation
(2004) - et al.
Análisis de la asistencia a la parada cardiorrespiratoria por una Unidad Medicalizada de Emergencias
Aten Primaria
(2011) - et al.
Is there a difference between women and men in characteristics and outcome after in hospital cardiac arrest?
Resuscitation
(2001) - et al.
Sex differences in outcome after ventricular fibrillation in out-of-hospital cardiac arrest
Resuscitation
(2005) - et al.
Estudio poblacional de la muerte súbita cardiovascular extrahospitalaria: incidencia y causas de muerte en adultos de edad mediana
Rev Esp Cardiol
(2011) - et al.
Characteristics and outcome among patients suffering from out of hospital cardiac arrest of noncardiac aetiology
Resuscitation
(2003) Muerte súbita extrahospitalaria en España
- et al.
Out-of-hospital cardiac arrest. Resuscitation in Spain
Resuscitation
(2000)