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, 75 (2), 311-22

A Model of Survival Following Pre-Hospital Cardiac Arrest Based on the Victorian Ambulance Cardiac Arrest Register

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A Model of Survival Following Pre-Hospital Cardiac Arrest Based on the Victorian Ambulance Cardiac Arrest Register

Masha Fridman et al. Resuscitation.

Abstract

Aims: This study describes the epidemiology of sudden cardiac arrest patients in Victoria, Australia, as captured via the Victorian Ambulance Cardiac Arrest Register (VACAR). We used the VACAR data to construct a new model of out-of-hospital cardiac arrest (OHCA), which was specified in accordance with observed trends.

Patients: All cases of cardiac arrest in Victoria that were attended by Victorian ambulance services during the period of 2002-2005.

Results: Overall survival to hospital discharge was 3.8% among 18,827 cases of OHCA. Survival was 15.7% among 1726 bystander witnessed, adult cardiac arrests of presumed cardiac aetiology, presenting in ventricular fibrillation or ventricular tachycardia (VF/VT), where resuscitation was attempted. In multivariate logistic regression analysis, bystander CPR, cardiac arrest (CA) location, response time, age and sex were predictors of VF/VT, which, in turn, was a strong predictor of survival. The same factors that affected VF/VT made an additional contribution to survival. However, for bystander CPR, CA location and response time this additional contribution was limited to VF/VT patients only. There was no detectable association between survival and age younger than 60 years or response time over 15min.

Conclusion: The new model accounts for relationships among predictors of survival. These relationships indicate that interventions such as reduced response times and bystander CPR act in multiple ways to improve survival.

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