Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar

A nationwide observational study

Furqan B. Irfan, Zain Ali Bhutta, Maaret Castren, Lahn Straney, Therese Djarv, Tooba Tariq, Stephen Hodges Thomas, Guillaume Alinier, Loua Al Shaikh, Robert Campbell Owen, Jassim Al Suwaidi, Ashfaq Shuaib, Rajvir Singh, Peter Alistair Cameron

Research output: Contribution to journalArticleResearchpeer-review

4 Citations (Scopus)

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) studies from the Middle East and Asian region are limited. This study describes the epidemiology, emergency health services, and outcomes of OHCA in Qatar. 

Methods: This was a prospective nationwide population-based observational study on OHCA patients in Qatar according to Utstein style guidelines, from June 2012 to May 2013. Data was collected from various sources; the national emergency medical service, 4 emergency departments, and 8 public hospitals. 

Results: The annual crude incidence of presumed cardiac OHCA attended by EMS was 23.5 per 100,000. The age-sex standardized incidence was 87.8 per 100,000 population. Of the 447 OHCA patients included in the final analysis, most were male (n = 360, 80.5%) with median age of 51 years (IQR = 39–66). Frequently observed nationalities were Qatari (n = 89, 19.9%), Indian (n = 74, 16.6%) and Nepalese (n = 52, 11.6%). Bystander cardiopulmonary resuscitation (CPR) was carried out in 92 (20.6%) OHCA patients. Survival rate was 8.1% (n = 36) and multivariable logistic regression indicated that initial shockable rhythm (OR 13.4, 95% CI 5.4–33.3, p = 0.001) was associated with higher odds of survival while male gender (OR 0.27, 95% CI 0.1–0.8, p = 0.01) and advanced cardiac life support (ACLS) (OR 0.15, 95% CI 0.04–0.5, p = 0.02) were associated with lower odds of survival. 

Conclusions: Standardized incidence and survival rates were comparable to Western countries. Although expatriates comprise more than 80% of the population, Qataris contributed 20% of the total cardiac arrests observed. There are significant opportunities to improve outcomes, including community-based CPR and defibrillation training.

Original languageEnglish
Pages (from-to)1007-1013
Number of pages7
JournalInternational Journal of Cardiology
Volume223
DOIs
Publication statusPublished - 15 Nov 2016

Keywords

  • Asia
  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Emergency Medical Services
  • Epidemiology
  • Middle East

Cite this

Irfan, Furqan B. ; Bhutta, Zain Ali ; Castren, Maaret ; Straney, Lahn ; Djarv, Therese ; Tariq, Tooba ; Thomas, Stephen Hodges ; Alinier, Guillaume ; Al Shaikh, Loua ; Owen, Robert Campbell ; Al Suwaidi, Jassim ; Shuaib, Ashfaq ; Singh, Rajvir ; Cameron, Peter Alistair. / Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar : A nationwide observational study. In: International Journal of Cardiology. 2016 ; Vol. 223. pp. 1007-1013.
@article{aff2e43791d84b479159d31b1907e985,
title = "Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar: A nationwide observational study",
abstract = "Background: Out-of-hospital cardiac arrest (OHCA) studies from the Middle East and Asian region are limited. This study describes the epidemiology, emergency health services, and outcomes of OHCA in Qatar. Methods: This was a prospective nationwide population-based observational study on OHCA patients in Qatar according to Utstein style guidelines, from June 2012 to May 2013. Data was collected from various sources; the national emergency medical service, 4 emergency departments, and 8 public hospitals. Results: The annual crude incidence of presumed cardiac OHCA attended by EMS was 23.5 per 100,000. The age-sex standardized incidence was 87.8 per 100,000 population. Of the 447 OHCA patients included in the final analysis, most were male (n = 360, 80.5{\%}) with median age of 51 years (IQR = 39–66). Frequently observed nationalities were Qatari (n = 89, 19.9{\%}), Indian (n = 74, 16.6{\%}) and Nepalese (n = 52, 11.6{\%}). Bystander cardiopulmonary resuscitation (CPR) was carried out in 92 (20.6{\%}) OHCA patients. Survival rate was 8.1{\%} (n = 36) and multivariable logistic regression indicated that initial shockable rhythm (OR 13.4, 95{\%} CI 5.4–33.3, p = 0.001) was associated with higher odds of survival while male gender (OR 0.27, 95{\%} CI 0.1–0.8, p = 0.01) and advanced cardiac life support (ACLS) (OR 0.15, 95{\%} CI 0.04–0.5, p = 0.02) were associated with lower odds of survival. Conclusions: Standardized incidence and survival rates were comparable to Western countries. Although expatriates comprise more than 80{\%} of the population, Qataris contributed 20{\%} of the total cardiac arrests observed. There are significant opportunities to improve outcomes, including community-based CPR and defibrillation training.",
keywords = "Asia, Cardiac arrest, Cardiopulmonary resuscitation, Emergency Medical Services, Epidemiology, Middle East",
author = "Irfan, {Furqan B.} and Bhutta, {Zain Ali} and Maaret Castren and Lahn Straney and Therese Djarv and Tooba Tariq and Thomas, {Stephen Hodges} and Guillaume Alinier and {Al Shaikh}, Loua and Owen, {Robert Campbell} and {Al Suwaidi}, Jassim and Ashfaq Shuaib and Rajvir Singh and Cameron, {Peter Alistair}",
year = "2016",
month = "11",
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language = "English",
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pages = "1007--1013",
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Irfan, FB, Bhutta, ZA, Castren, M, Straney, L, Djarv, T, Tariq, T, Thomas, SH, Alinier, G, Al Shaikh, L, Owen, RC, Al Suwaidi, J, Shuaib, A, Singh, R & Cameron, PA 2016, 'Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar: A nationwide observational study', International Journal of Cardiology, vol. 223, pp. 1007-1013. https://doi.org/10.1016/j.ijcard.2016.08.299

Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar : A nationwide observational study. / Irfan, Furqan B.; Bhutta, Zain Ali; Castren, Maaret; Straney, Lahn; Djarv, Therese; Tariq, Tooba; Thomas, Stephen Hodges; Alinier, Guillaume; Al Shaikh, Loua; Owen, Robert Campbell; Al Suwaidi, Jassim; Shuaib, Ashfaq; Singh, Rajvir; Cameron, Peter Alistair.

In: International Journal of Cardiology, Vol. 223, 15.11.2016, p. 1007-1013.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Epidemiology and outcomes of out-of-hospital cardiac arrest in Qatar

T2 - A nationwide observational study

AU - Irfan, Furqan B.

AU - Bhutta, Zain Ali

AU - Castren, Maaret

AU - Straney, Lahn

AU - Djarv, Therese

AU - Tariq, Tooba

AU - Thomas, Stephen Hodges

AU - Alinier, Guillaume

AU - Al Shaikh, Loua

AU - Owen, Robert Campbell

AU - Al Suwaidi, Jassim

AU - Shuaib, Ashfaq

AU - Singh, Rajvir

AU - Cameron, Peter Alistair

PY - 2016/11/15

Y1 - 2016/11/15

N2 - Background: Out-of-hospital cardiac arrest (OHCA) studies from the Middle East and Asian region are limited. This study describes the epidemiology, emergency health services, and outcomes of OHCA in Qatar. Methods: This was a prospective nationwide population-based observational study on OHCA patients in Qatar according to Utstein style guidelines, from June 2012 to May 2013. Data was collected from various sources; the national emergency medical service, 4 emergency departments, and 8 public hospitals. Results: The annual crude incidence of presumed cardiac OHCA attended by EMS was 23.5 per 100,000. The age-sex standardized incidence was 87.8 per 100,000 population. Of the 447 OHCA patients included in the final analysis, most were male (n = 360, 80.5%) with median age of 51 years (IQR = 39–66). Frequently observed nationalities were Qatari (n = 89, 19.9%), Indian (n = 74, 16.6%) and Nepalese (n = 52, 11.6%). Bystander cardiopulmonary resuscitation (CPR) was carried out in 92 (20.6%) OHCA patients. Survival rate was 8.1% (n = 36) and multivariable logistic regression indicated that initial shockable rhythm (OR 13.4, 95% CI 5.4–33.3, p = 0.001) was associated with higher odds of survival while male gender (OR 0.27, 95% CI 0.1–0.8, p = 0.01) and advanced cardiac life support (ACLS) (OR 0.15, 95% CI 0.04–0.5, p = 0.02) were associated with lower odds of survival. Conclusions: Standardized incidence and survival rates were comparable to Western countries. Although expatriates comprise more than 80% of the population, Qataris contributed 20% of the total cardiac arrests observed. There are significant opportunities to improve outcomes, including community-based CPR and defibrillation training.

AB - Background: Out-of-hospital cardiac arrest (OHCA) studies from the Middle East and Asian region are limited. This study describes the epidemiology, emergency health services, and outcomes of OHCA in Qatar. Methods: This was a prospective nationwide population-based observational study on OHCA patients in Qatar according to Utstein style guidelines, from June 2012 to May 2013. Data was collected from various sources; the national emergency medical service, 4 emergency departments, and 8 public hospitals. Results: The annual crude incidence of presumed cardiac OHCA attended by EMS was 23.5 per 100,000. The age-sex standardized incidence was 87.8 per 100,000 population. Of the 447 OHCA patients included in the final analysis, most were male (n = 360, 80.5%) with median age of 51 years (IQR = 39–66). Frequently observed nationalities were Qatari (n = 89, 19.9%), Indian (n = 74, 16.6%) and Nepalese (n = 52, 11.6%). Bystander cardiopulmonary resuscitation (CPR) was carried out in 92 (20.6%) OHCA patients. Survival rate was 8.1% (n = 36) and multivariable logistic regression indicated that initial shockable rhythm (OR 13.4, 95% CI 5.4–33.3, p = 0.001) was associated with higher odds of survival while male gender (OR 0.27, 95% CI 0.1–0.8, p = 0.01) and advanced cardiac life support (ACLS) (OR 0.15, 95% CI 0.04–0.5, p = 0.02) were associated with lower odds of survival. Conclusions: Standardized incidence and survival rates were comparable to Western countries. Although expatriates comprise more than 80% of the population, Qataris contributed 20% of the total cardiac arrests observed. There are significant opportunities to improve outcomes, including community-based CPR and defibrillation training.

KW - Asia

KW - Cardiac arrest

KW - Cardiopulmonary resuscitation

KW - Emergency Medical Services

KW - Epidemiology

KW - Middle East

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