Keywords
epidemiology
neurological prognosis
outcome
out-of-hospital
How to Cite
Abstract
Aim: The survival rate of out-of-hospital cardiac arrests (OHCA) remain slow in France (4.9%). The main objective of our study was to describe the management of OHCA in Loire and North Ardèche. Secondary objectives were to identify factors influencing survival and neurological prognosis at day 30 (D30).
Procedure: Retrospective study based on data from the French national register (RéAC) and including all OHCA for whom
resuscitation was undertaken from January 1, 2013 to August 31, 2018.
Results: The study included 1984 OHCA, 69% of whom were male, with a median age of 68 years old [55-80]. A witness was present in 1265 cases (64%) and started a cardiopulmonary resuscitation (CPR) in 44.5% of cases. The etiology was medical in 88.9% of cases. The initial rhythm was shockable in 6.4% of cases. Seventy-nine patients (4%) survived at day- 30, 56 of whom had a good neurological prognosis (2.8%). Factors improving survival were: early CPR and defibrillation (OR 2.21 [1.02-4.80]), the occurrence in a public place (OR 2.39 [1.27-4.52]) and the presence of gasps at the beginning of care (OR 3.27 [1.49-7.20]). Factors reducing survival were: traumatic etiology (OR 0.11 [0.01-0.85]), non-shockable rhythm (OR 0.09 [0.04-0.19]), advanced age (OR 0.96 [0.95-0.98]), longer no-flow time (OR 0.95 [0.91-0.99]) and an adrenaline dose
≥ 3 mg (OR 0.09 [0.04-0.18]). The same factors influenced the neurological prognosis at D30.
Conclusion: Our data were comparable to national data. The intervention of witnesses is crucial on the prognosis and needs to be encouraged.
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