Premium
Pre‐hospital outcomes of adult out‐of‐hospital cardiac arrest of presumed cardiac aetiology in Queensland, Australia (2002–2014): Trends over time
Author(s) -
Pemberton Katherine,
Bosley Emma,
C Franklin Richard,
Watt Kerrianne
Publication year - 2019
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.13353
Subject(s) - return of spontaneous circulation , medicine , resuscitation , incidence (geometry) , etiology , emergency medicine , cardiopulmonary resuscitation , retrospective cohort study , cohort , population , hospital discharge , medical emergency , intensive care medicine , environmental health , physics , optics
Objective To describe temporal trends in incidence of pre‐hospital outcomes from adult out‐of‐hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics between 2002 and 2014, by age, gender, geographical remoteness and socio‐economic status. Methods Cases included in this retrospective cohort study were identified from the QAS OHCA Registry. Included cases were linked with Queensland Hospital Admitted Patient Data Collection and Queensland Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence rates for each year. Analyses were undertaken by four mutually exclusive pre‐hospital outcomes: (i) no resuscitation (No‐Resus); (ii) resuscitation, no pre‐hospital return of spontaneous circulation (No‐ROSC); (iii) resuscitation, pre‐hospital return of spontaneous circulation not sustained to hospital (Unsustained‐ROSC); and (iv) resuscitation, pre‐hospital return of spontaneous circulation sustained to hospital (Sustained‐ROSC). Trends over time were analysed for crude and specific rates for total OHCA events and for each outcome. Results Between 2002 and 2014, there were 30 560 OHCA cases. Crude incidence significantly increased over time for No‐Resus and Sustained‐ROSC, and significantly decreased for No‐ROSC. These trends were reflected in major cities, inner and outer regional areas. There was a significant increase in Sustained‐ROSC in remote areas, and no significant trends in very remote areas. Conclusion Incidence of withholding resuscitation and ROSC sustained to hospital have independently increased over time. Factors of middle age, more rural location and lower socio‐economic status should all be targeted in the development and implementation of future strategies.