Outcomes following out-of-hospital cardiac arrest with an initial cardiac rhythm of asystole or pulseless electrical activity in Victoria, Australia

Emily P Andrew, Ziad Nehme, Marijana Lijovic, Stephen Anthony Bernard, Karen Louise Smith

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: While internationally reported survival from out-of-hospital cardiac arrest (OHCA) is improving, much of the increase is being observed in patients presenting to emergency medical services (EMS) in shockable rhythms. The purpose of this study was to assess survival and 12-month functional recovery in patients presenting to EMS in asystole or pulseless electrical activity (PEA). Methods: The Victorian Ambulance Cardiac Arrest Registry was searched for adult OHCA patients presenting in non-shockable rhythms in Victoria, Australia between 1st July 2003 and 30th June 2013. We excluded patients defibrillated prior to EMS arrival and arrests witnessed by EMS. Twelve-month quality-of-life interviews were conducted on survivors who arrested between 1st January 2010 and 31st December 2012. The main outcome measures were survival to hospital discharge and 12-month functional recovery measured by the Extended Glasgow Outcome Scale (GOSE). Results: A total of 38,378 non-shockable OHCA attended by EMS were included, of which 88.0 were asystole and 11.6 were PEA. Of the patients receiving resuscitation, survival to hospital discharge was 1.1 for asystole and 5.9 for PEA (p <0.001), with no significant improvement observed over the 10 year study period. In survivors with 12-month follow-up data, the combined rate of death, vegetative state or lower severe disability was 66.7 (95 CI 41.0-80.0 ) for asystole and 44.7 (95 CI 30.2-59.9 ) for PEA. Conclusion: Survival outcomes following OHCA with initial rhythms of asystole or PEA did not improve over the 10-year study period. Our findings indicate high rates of death within 12 months, and unfavourable functional recovery for survivors.
Original languageEnglish
Pages (from-to)1633 - 1639
Number of pages7
JournalResuscitation
Volume85
Issue number11
DOIs
Publication statusPublished - 2014

Cite this

@article{fec2da76f01842b8851f821c98ba7ef7,
title = "Outcomes following out-of-hospital cardiac arrest with an initial cardiac rhythm of asystole or pulseless electrical activity in Victoria, Australia",
abstract = "Background: While internationally reported survival from out-of-hospital cardiac arrest (OHCA) is improving, much of the increase is being observed in patients presenting to emergency medical services (EMS) in shockable rhythms. The purpose of this study was to assess survival and 12-month functional recovery in patients presenting to EMS in asystole or pulseless electrical activity (PEA). Methods: The Victorian Ambulance Cardiac Arrest Registry was searched for adult OHCA patients presenting in non-shockable rhythms in Victoria, Australia between 1st July 2003 and 30th June 2013. We excluded patients defibrillated prior to EMS arrival and arrests witnessed by EMS. Twelve-month quality-of-life interviews were conducted on survivors who arrested between 1st January 2010 and 31st December 2012. The main outcome measures were survival to hospital discharge and 12-month functional recovery measured by the Extended Glasgow Outcome Scale (GOSE). Results: A total of 38,378 non-shockable OHCA attended by EMS were included, of which 88.0 were asystole and 11.6 were PEA. Of the patients receiving resuscitation, survival to hospital discharge was 1.1 for asystole and 5.9 for PEA (p <0.001), with no significant improvement observed over the 10 year study period. In survivors with 12-month follow-up data, the combined rate of death, vegetative state or lower severe disability was 66.7 (95 CI 41.0-80.0 ) for asystole and 44.7 (95 CI 30.2-59.9 ) for PEA. Conclusion: Survival outcomes following OHCA with initial rhythms of asystole or PEA did not improve over the 10-year study period. Our findings indicate high rates of death within 12 months, and unfavourable functional recovery for survivors.",
author = "Andrew, {Emily P} and Ziad Nehme and Marijana Lijovic and Bernard, {Stephen Anthony} and Smith, {Karen Louise}",
year = "2014",
doi = "10.1016/j.resuscitation.2014.07.015",
language = "English",
volume = "85",
pages = "1633 -- 1639",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier",
number = "11",

}

Outcomes following out-of-hospital cardiac arrest with an initial cardiac rhythm of asystole or pulseless electrical activity in Victoria, Australia. / Andrew, Emily P; Nehme, Ziad; Lijovic, Marijana; Bernard, Stephen Anthony; Smith, Karen Louise.

In: Resuscitation, Vol. 85, No. 11, 2014, p. 1633 - 1639.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Outcomes following out-of-hospital cardiac arrest with an initial cardiac rhythm of asystole or pulseless electrical activity in Victoria, Australia

AU - Andrew, Emily P

AU - Nehme, Ziad

AU - Lijovic, Marijana

AU - Bernard, Stephen Anthony

AU - Smith, Karen Louise

PY - 2014

Y1 - 2014

N2 - Background: While internationally reported survival from out-of-hospital cardiac arrest (OHCA) is improving, much of the increase is being observed in patients presenting to emergency medical services (EMS) in shockable rhythms. The purpose of this study was to assess survival and 12-month functional recovery in patients presenting to EMS in asystole or pulseless electrical activity (PEA). Methods: The Victorian Ambulance Cardiac Arrest Registry was searched for adult OHCA patients presenting in non-shockable rhythms in Victoria, Australia between 1st July 2003 and 30th June 2013. We excluded patients defibrillated prior to EMS arrival and arrests witnessed by EMS. Twelve-month quality-of-life interviews were conducted on survivors who arrested between 1st January 2010 and 31st December 2012. The main outcome measures were survival to hospital discharge and 12-month functional recovery measured by the Extended Glasgow Outcome Scale (GOSE). Results: A total of 38,378 non-shockable OHCA attended by EMS were included, of which 88.0 were asystole and 11.6 were PEA. Of the patients receiving resuscitation, survival to hospital discharge was 1.1 for asystole and 5.9 for PEA (p <0.001), with no significant improvement observed over the 10 year study period. In survivors with 12-month follow-up data, the combined rate of death, vegetative state or lower severe disability was 66.7 (95 CI 41.0-80.0 ) for asystole and 44.7 (95 CI 30.2-59.9 ) for PEA. Conclusion: Survival outcomes following OHCA with initial rhythms of asystole or PEA did not improve over the 10-year study period. Our findings indicate high rates of death within 12 months, and unfavourable functional recovery for survivors.

AB - Background: While internationally reported survival from out-of-hospital cardiac arrest (OHCA) is improving, much of the increase is being observed in patients presenting to emergency medical services (EMS) in shockable rhythms. The purpose of this study was to assess survival and 12-month functional recovery in patients presenting to EMS in asystole or pulseless electrical activity (PEA). Methods: The Victorian Ambulance Cardiac Arrest Registry was searched for adult OHCA patients presenting in non-shockable rhythms in Victoria, Australia between 1st July 2003 and 30th June 2013. We excluded patients defibrillated prior to EMS arrival and arrests witnessed by EMS. Twelve-month quality-of-life interviews were conducted on survivors who arrested between 1st January 2010 and 31st December 2012. The main outcome measures were survival to hospital discharge and 12-month functional recovery measured by the Extended Glasgow Outcome Scale (GOSE). Results: A total of 38,378 non-shockable OHCA attended by EMS were included, of which 88.0 were asystole and 11.6 were PEA. Of the patients receiving resuscitation, survival to hospital discharge was 1.1 for asystole and 5.9 for PEA (p <0.001), with no significant improvement observed over the 10 year study period. In survivors with 12-month follow-up data, the combined rate of death, vegetative state or lower severe disability was 66.7 (95 CI 41.0-80.0 ) for asystole and 44.7 (95 CI 30.2-59.9 ) for PEA. Conclusion: Survival outcomes following OHCA with initial rhythms of asystole or PEA did not improve over the 10-year study period. Our findings indicate high rates of death within 12 months, and unfavourable functional recovery for survivors.

UR - http://www.sciencedirect.com/science/article/pii/S0300957214006789

U2 - 10.1016/j.resuscitation.2014.07.015

DO - 10.1016/j.resuscitation.2014.07.015

M3 - Article

VL - 85

SP - 1633

EP - 1639

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

IS - 11

ER -