A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand
Issued Date
2022-03-01
Resource Type
eISSN
26665204
Scopus ID
2-s2.0-85128990909
Journal Title
Resuscitation Plus
Volume
9
Rights Holder(s)
SCOPUS
Bibliographic Citation
Resuscitation Plus Vol.9 (2022)
Suggested Citation
Sirikul W., Piankusol C., Wittayachamnankul B., Riyapan S., Supasaovapak J., Wongtanasarasin W., McNally B. A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand. Resuscitation Plus Vol.9 (2022). doi:10.1016/j.resplu.2021.100196 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86039
Title
A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand
Other Contributor(s)
Abstract
Objective: This study aimed to explore significant pre-hospital factors affecting the survivability of Out-of-Hospital Cardiac Arrest (OHCA) patients in countries with developing EMS systems. Method: A retrospective cohort study was conducted examining data from January 1, 2017 to December 31, 2020 from Utstein Registry databases in Thailand, collected through Pan-Asian Resuscitation Outcomes Study (PAROS). Data were collected from three centres, including regional, suburban-capital, and urban-capital hospitals. The primary endpoint of this study was 30-day survival or discharged alive after an OHCA event. The multivariable risk regression was done by modified Poisson regression with robust error variance to explore the association between 30-day survival and pre-hospital factors with potential confounders adjustments. Findings: Of 1,240 OHCA cases transferred by Emergency Medical Services (EMS), 42 patients (3.4%) were discharged alive after 30 days, including 22 (8.6%), 8 (3.0%), and 12 (1.7%) from regional, suburban-capital, and urban-capital centres, respectively. The initial arrest rhythm was 89.7% unshockable, with no significant variations across the three centres. Overall, bystander Cardiopulmonary Resuscitation (CPR) was 40.4%. However, bystander CPR with Automated External Defibrillator (AED) application was 0.8%. Bystander CPR significantly increased 30-day survival probability (aRR 1.88, 95% CI 1.01 to 3.51; p 0.049). Additionally, reducing the EMS response time by one minute significantly increased OHCA survivability (aRR 1.12, 95% CI 1.04 to 1.20; p 0.001). Conclusions: Response time and bystander CPR are the factors that improve the 30-day survival outcomes of OHCA patients. In contrast, scene time, transport time, and pre-hospital advanced airway management didn't improve 30-day OHCA survival.