Acute cardiac care & resuscitationCohort study
Impact of system efficiency on out-of-hospital cardiac arrest outcomes and hospital stay: an observational study from Lombardia CARe
- retrospective cohort study
- Lombardia Cardiac Arrest Registry
- Multivariate logistic regression models
Authors' conclusion
System responsiveness is a key modifiable factor influencing outcomes after OHCA, with each minute of EMS delay substantially reducing survival odds. Enhancing the entire chain of survival is essential to improve patient outcomes and reduce the indirect societal costs associated with OHCA.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) cases, Lombardia Cardiac Arrest Registry, 2015–2023OHCA cases (2015–2023) · sub-cohort of hospitalized patients 515
- Participants
- 12,532 participants
- Exposure
- relationship between emergency medical service (EMS) arrival time and prehospital mortality, as well as long-term outcomes according to system efficiency
Main finding
Prehospital event mortality by EMS response time
Odds ratio
1.03 per minute
95% CI 1.02–1.05
Each additional minute of EMS delay, as printed
As reported in the abstract
- Prehospital event mortality increased with longer EMS response time
- from 74.7 to 93.2%
Observational data: associations, not effects.
Further findings
Survival at hospital admission
Survival · 12 months
| Outcome | Higher system efficiency | less efficient systems |
|---|---|---|
| Costs per survivor · 12 months follow-up | €48 985 | €61 781 |
Neurological outcomes and discharge survival among hospitalized patients
- Improved with higher system efficiency
Hospital costs
- Higher hospital costs among patients in the high-efficiency system group
Original publication
Summarised from the published abstract; every number is checked against it