Epidemiology and outcomes from out-of-hospital cardiac arrests in England

Claire Hawkes; Scott Booth; Chen Ji; Samantha J Brace-McDonnell; Andrew Whittington; James Mapstone; Matthew W Cooke; Charles D Deakin; Chris P Gale; Rachael Fothergill; Jerry P Nolan; Nigel Rees; Jasmeet Soar; A Niroshan Siriwardena; Terry P Brown; Gavin D Perkins; OHCAO collaborators

doi:10.1016/j.resuscitation.2016.10.030

Epidemiology and outcomes from out-of-hospital cardiac arrests in England

Resuscitation. 2017 Jan:110:133-140. doi: 10.1016/j.resuscitation.2016.10.030. Epub 2016 Nov 17.

Authors

Claire Hawkes¹, Scott Booth¹, Chen Ji¹, Samantha J Brace-McDonnell², Andrew Whittington¹, James Mapstone³, Matthew W Cooke¹, Charles D Deakin⁴, Chris P Gale⁵, Rachael Fothergill⁶, Jerry P Nolan⁷, Nigel Rees⁸, Jasmeet Soar⁹, A Niroshan Siriwardena¹⁰, Terry P Brown¹, Gavin D Perkins¹¹; OHCAO collaborators

Affiliations

¹ Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL UK.
² Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL UK; Heart of England NHS Foundation Trust, Birmingham, UK.
³ South of England, Public Health England, UK.
⁴ NIHR Southampton Respiratory BRU, University Hospital Southampton, Southampton, UK.
⁵ MRC Bioinformatics Unit, LICAM, University of Leeds, Leeds, UK.
⁶ London Ambulance Service NHS Trust, London, UK.
⁷ Royal United Hospitals, Bath, UK.
⁸ Welsh Ambulance Service NHS Trust, Cardiff, UK.
⁹ Southmead Hospital, Bristol, UK.
¹⁰ University of Lincoln, Lincolnshire, UK.
¹¹ Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL UK; Heart of England NHS Foundation Trust, Birmingham, UK. Electronic address: g.d.perkins@warwick.ac.uk.

PMID: 27865775
DOI: 10.1016/j.resuscitation.2016.10.030

Abstract

Introduction: This study reports the epidemiology and outcomes from out-of-hospital cardiac arrest (OHCA) in England during 2014.

Methods: Prospective observational study from the national OHCA registry. The incidence, demographic and outcomes of patients who were treated for an OHCA between 1st January 2014 and 31st December 2014 in 10 English ambulance service (EMS) regions, serving a population of almost 54 million, are reported in accordance with Utstein recommendations.

Results: 28,729 OHCA cases of EMS treated cardiac arrests were reported (53 per 100,000 of resident population). The mean age was 68.6 (SD=19.6) years and 41.3% were female. Most (83%) occurred in a place of residence, 52.7% were witnessed by either the EMS or a bystander. In non-EMS witnessed cases, 55.2% received bystander CPR whilst public access defibrillation was used rarely (2.3%). Cardiac aetiology was the leading cause of cardiac arrest (60.9%). The initial rhythm was asystole in 42.4% of all cases and was shockable (VF or pVT) in 20.6%. Return of spontaneous circulation at hospital transfer was evident in 25.8% (n=6302) and survival to hospital discharge was 7.9%.

Conclusion: Cardiac arrest is an important cause of death in England. With less than one in ten patients surviving, there is scope to improve outcomes. Survival rates were highest amongst those who received bystander CPR and public access defibrillation.

Keywords: Cardiac arrest; Emergency medical services; Out-of-hospital cardiac arrest; Pre-hospital care; Resuscitation.

Publication types

Observational Study

MeSH terms

Adult
Aged
Cardiopulmonary Resuscitation* / methods
Cardiopulmonary Resuscitation* / statistics & numerical data
Demography
Emergency Medical Services* / methods
Emergency Medical Services* / statistics & numerical data
England / epidemiology
Female
Heart Diseases* / complications
Heart Diseases* / epidemiology
Humans
Incidence
Male
Middle Aged
Needs Assessment
Out-of-Hospital Cardiac Arrest* / etiology
Out-of-Hospital Cardiac Arrest* / mortality
Out-of-Hospital Cardiac Arrest* / therapy
Outcome and Process Assessment, Health Care
Patient Discharge / statistics & numerical data
Prospective Studies
Registries / statistics & numerical data
Survival Rate