TY - JOUR
T1 - The epidemiology of out-of-hospital cardiac arrest in Australia and New Zealand
T2 - A binational report from the Australasian Resuscitation Outcomes Consortium (Aus-ROC)
AU - Bray, Janet
AU - Howell, Stuart
AU - Ball, Stephen
AU - Doan, Tan
AU - Bosley, Emma
AU - Smith, Karen
AU - Dicker, Bridget
AU - Faddy, Steven
AU - Thorrowgood, Melanie
AU - Swain, Andy
AU - Thomas, Andrew
AU - Wilson, Alexander
AU - Shipp, Carol
AU - Walker, Tony
AU - Bailey, Paul
AU - Finn, Judith
AU - Aus-ROC Epistry Management Committee
N1 - Funding Information:
The authors would like to thank the registry staff in each of the participating ambulance services for their contribution. We also wish to acknowledge the vision of the late Professor Ian Jacob's -to have a complete regional Aus-ROC OHCA Epistry. Janet Bray, Stuart Howell, Stephen Ball, Tan Doan, Emma Bosley, Karen Smith, Bridget Dicker, Steven Faddy, Melanie Thorrowgood, Andy Swain, Andrew Thomas, Alexander Wilson, Carol Shipp, Tony Walker, Paul Bailey, Judith Finn, Tony Smith, Stephen Bernard, Hugh Grantham, Damien Norsworthy, Howard Wren, Keith Driscoll, Mike McDermott, Abhishek Ranjan, Richard Larsen, Samuel Perillo, Con Georgakas, Jeff Waters, Peter Cameron, Graham Nichol, and Gavin Perkins. Members of the Aus-ROC Epistry Management Committee who are not authors on the manuscript should be listed as collaborators. The Epistry was established and continues to be funded by National Health and Medical Research Council (NHMRC) Centre of Research Excellences: Aus-ROC (#1029983) and Prehospital Emergency Care (#1116453). JB is funded by a Heart Foundation Fellowship (#104751). JF is funded by a NHMRC Investigator Grant (#1174838).
Funding Information:
The Epistry was established and continues to be funded by National Health and Medical Research Council (NHMRC) Centre of Research Excellences: Aus-ROC (# 1029983 ) and Prehospital Emergency Care (# 1116453 ). JB is funded by a Heart Foundation Fellowship (# 104751 ). JF is funded by a NHMRC Investigator Grant (# 1174838 ).
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/3
Y1 - 2022/3
N2 - Introduction: The Australasian Resuscitation Outcomes Consortium (Aus-ROC) out-of-hospital cardiac arrest (OHCA) Epistry (Epidemiological Registry) now covers 100% of Australia and New Zealand (NZ). This study reports and compares the Utstein demographics, arrest characteristics and outcomes of OHCA patients across our region. Methods: We included all OHCA cases throughout 2019 as submitted to the Epistry by the eight Australian and two NZ emergency medical services (EMS). We calculated crude and age-standardised incidence rates and performed a national and EMS regional comparison. Results: We obtained data for 31,778 OHCA cases for 2019: 26,637 in Australia and 5,141 in NZ. Crude incidence was 107.9 per 100,000 person-years in Australia and 103.2/100,000 in NZ. Overall, the majority of OHCAs occurred in adults (96%), males (66%), private residences (76%), were unwitnessed (63%), of presumed medical aetiology (83%), and had an initial monitored rhythm of asystole (64%). In non-EMS-witnessed cases, 38% received bystander CPR and 2% received public defibrillation. Wide variation was seen between EMS regions for all OHCA demographics, arrest characteristics and outcomes. In patients who received an EMS-attempted resuscitation (13,664/31,778): 28% (range across EMS = 13.1% to 36.7%) had return of spontaneous circulation (ROSC) at hospital arrival and 13% (range across EMS = 9.9% to 20.7%) survived to hospital discharge/30-days. Survival in the Utstein comparator group (bystander-witnessed in shockable rhythm) varied across the EMS regions between 27.4% to 42.0%. Conclusion: OHCA across Australia and NZ has varied incidence, characteristics and survival. Understanding the variation in survival and modifiable predictors is key to informing strategies to improve outcomes.
AB - Introduction: The Australasian Resuscitation Outcomes Consortium (Aus-ROC) out-of-hospital cardiac arrest (OHCA) Epistry (Epidemiological Registry) now covers 100% of Australia and New Zealand (NZ). This study reports and compares the Utstein demographics, arrest characteristics and outcomes of OHCA patients across our region. Methods: We included all OHCA cases throughout 2019 as submitted to the Epistry by the eight Australian and two NZ emergency medical services (EMS). We calculated crude and age-standardised incidence rates and performed a national and EMS regional comparison. Results: We obtained data for 31,778 OHCA cases for 2019: 26,637 in Australia and 5,141 in NZ. Crude incidence was 107.9 per 100,000 person-years in Australia and 103.2/100,000 in NZ. Overall, the majority of OHCAs occurred in adults (96%), males (66%), private residences (76%), were unwitnessed (63%), of presumed medical aetiology (83%), and had an initial monitored rhythm of asystole (64%). In non-EMS-witnessed cases, 38% received bystander CPR and 2% received public defibrillation. Wide variation was seen between EMS regions for all OHCA demographics, arrest characteristics and outcomes. In patients who received an EMS-attempted resuscitation (13,664/31,778): 28% (range across EMS = 13.1% to 36.7%) had return of spontaneous circulation (ROSC) at hospital arrival and 13% (range across EMS = 9.9% to 20.7%) survived to hospital discharge/30-days. Survival in the Utstein comparator group (bystander-witnessed in shockable rhythm) varied across the EMS regions between 27.4% to 42.0%. Conclusion: OHCA across Australia and NZ has varied incidence, characteristics and survival. Understanding the variation in survival and modifiable predictors is key to informing strategies to improve outcomes.
KW - Emergency medical services
KW - Epidemiology
KW - Heart arrest
KW - Out-of-hospital cardiac arrest
KW - Registry
KW - Resuscitation
UR - http://www.scopus.com/inward/record.url?scp=85124001295&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2022.01.011
DO - 10.1016/j.resuscitation.2022.01.011
M3 - Article
C2 - 35077857
AN - SCOPUS:85124001295
SN - 0300-9572
VL - 172
SP - 74
EP - 83
JO - Resuscitation
JF - Resuscitation
ER -