Neurological outcomes after an out-of-hospital cardiac arrest among people living in high-rise buildings in South Korea

Eur J Emerg Med. 2020 Jun;27(3):207-212. doi: 10.1097/MEJ.0000000000000643.

Abstract

Objective: Living in high-rise buildings may cause delays in reaching a hospital after an out-of-hospital cardiac arrest. This study aimed to compare neurological outcomes in people who had had an out-of-hospital cardiac arrest, according to their floor of residence.

Methods: We conducted a retrospective study of 1541 patients aged ≥20 years who had out-of-hospital cardiac arrest between 1 October 2015 and 30 June 2018, using data from a central registry. We compared the outcomes of patients living on the first (ground) or second floor and those living on the third floor or above, using multiple logistic regression.

Results: Those living on higher floors were more likely to have been at home (88.1% vs. 58.0%); to have had bystander cardiopulmonary resuscitation (57.9% vs. 45.2%); and experienced a significantly longer emergency medical service response time [median interquartile range (IQR): 7 min (6-10 min) vs. 7 min (5-9 min), P = 0.001] and on-scene time [median (IQR): 16 min (11-23 min) vs. 12 min (8-19 min), P < 0.001]. The strongest predictors of a good neurological outcome were younger age [odds ratio (OR): 0.96, 95% confidence interval (CI): 0.94-0.97], being on a lower floor at the time of the cardiac arrest (OR: 1.82, 95% CI: 1.09-3.12) and having a shockable rhythm (OR: 21.97, 95% CI: 12.81-39.47).

Conclusion: People living on higher floors have poorer outcomes after an out-of-hospital cardiac arrest. Further studies are required to assess factors causing a delay in the emergency medical service response time, and placement of automated external defibrillators in high-rise buildings.

MeSH terms

  • Cardiopulmonary Resuscitation*
  • Emergency Medical Services*
  • Humans
  • Out-of-Hospital Cardiac Arrest* / epidemiology
  • Out-of-Hospital Cardiac Arrest* / therapy
  • Registries
  • Republic of Korea / epidemiology
  • Retrospective Studies