151. Temporal Trends of Out-of-Hospital Cardiac Arrests Without Resuscitation Attempt by Emergency Medical Services
- Author
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Ardalan Sharifzadehgan, Patricia Jabre, Alain Cariou, Thomas Loeb, Wulfran Bougouin, Frankie Beganton, Nicole Karam, François Revaux, Daniel Jost, Bertrand Ludes, Jean-Marc Agostinucci, Lionel Lamhaut, Bamba Gaye, Florence Dumas, Kumar Narayanan, Bruno Mégarbane, Frédéric Adnet, on behalf Paris-SDEC investigators, Xavier Jouven, Eloi Marijon, Victor Waldmann, Haoiinda Kassim, Sandrine Deltour, Sebastian Voicu, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Medicover Hospitals, Hyderabad, India, SAMU 75 [Paris], SAMU 92 [Garches], Hôpital Raymond Poincaré [AP-HP], SAMU 93 [Bobigny], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Lariboisière-Fernand-Widal [APHP], and Mégarbane, Bruno
- Subjects
Male ,Emergency Medical Services ,medicine.medical_specialty ,Resuscitation ,resuscitation ,Population ,population ,030204 cardiovascular system & hematology ,survival ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Out of hospital cardiac arrest ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Emergency medical services ,Humans ,Medicine ,Prospective Studies ,030212 general & internal medicine ,education ,Aged ,[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,Aged, 80 and over ,Out of hospital ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,education.field_of_study ,business.industry ,Editorials ,Original Articles ,Middle Aged ,ventricular fibrillation ,Cardiopulmonary Resuscitation ,[SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.TOX] Life Sciences [q-bio]/Toxicology ,Survival Rate ,Editorial ,[SDV.TOX]Life Sciences [q-bio]/Toxicology ,Emergency medicine ,[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Female ,Cardiology and Cardiovascular Medicine ,business ,Out-of-Hospital Cardiac Arrest - Abstract
Background: Significant improvements in survival from out-of-hospital cardiac arrest (OHCA) have been reported; however, these are based only on data from OHCA in whom resuscitation is initiated by emergency medical services (EMS). We aimed to assess the characteristics and temporal trends of OHCA without resuscitation attempt by EMS. Methods: Prospective population-based study between 2011 and 2016 in the Greater Paris area (6.7 million inhabitants). All cases of OHCA were included in collaboration with EMS units, 48 different hospitals, and forensic units. Results: Among 15 207 OHCA (mean age 70.7±16.9 years, 61.6% male), 5486 (36.1%) had no resuscitation attempt by EMS. Factors that were independently associated with increase in likelihood of no resuscitation attempt included: age of patients (odds ratio, 1.06 per year [95% CI, 1.05–1.06], P P =0.002), OHCA at home location (odds ratio, 3.38 [95%CI, 2.86–4.01], P P P =0.028). This increase was related to an increase of the annual number of OHCA without resuscitation attempt by EMS by 26.3% (from 993 to 1253, P =0.012), while the annual number of OHCA with resuscitation attempt by EMS did not significantly change (from 1930 to 1936, P =0.416). Considering only cases with resuscitation attempt, survival rate at hospital discharge increased (from 7.3% to 9.5%, P =0.02). However, when considering all OHCA, survival improvement did not reach statistical significance (from 4.8% to 5.7%, P =0.17). Conclusions: We demonstrated an increase of the total number of OHCA related to an increase of the number of OHCA without resuscitation attempt by EMS. This increasing proportion of OHCA without resuscitation attempt attenuates improvement in survival rates achieved in EMS-treated patients.
- Published
- 2021