Acute cardiac care & resuscitationCohort study
Temporal Patterns in Out-of-Hospital Cardiac Arrest Incidence and Outcome
- Retrospective cohort study
Authors' conclusion
Results suggest that the overall OHCA incidence did not change over time, although there were differential temporal patterns among clinical subgroups. Survival improved over time overall and according to presenting rhythm, corresponding to favorable trends in community responder, prehospital, and hospital care.
Study context
- Population
- Adults with OHCA treated by emergency medical services (EMS), King County, Washington, 2001–2020
- Participants
- 25,118 adults · 30,884,504 person-years
- Exposure
- Temporal trends 2001–2020
- Outcome
- Annual OHCA incidence per 100 000 person-years (AAC %) and survival to hospital discharge
Main finding
As reported in the abstract
- Overall incidence per 100 000 person-years
- 81.3
- Overall incidence 2001 vs 2020 per 100 000 person-years
- 88.7 vs 82.1
- Overall incidence average annualized change (AAC)
- −0.5% (−0.9% to 0%) (95% CI)
- Overall survival to hospital discharge
- 17.7%
- Survival to discharge 2001-2005
- 14.7% (859 of 5847)
- Survival to discharge 2006-2010
- 17.4% (1024 of 5885)
- Survival to discharge 2011-2015
- 19.3% (1232 of 6376)
- Survival to discharge 2016-2020
- 18.9% (1322 of 7010)
- Survival trend
- P < .001
Observational data: associations, not effects.
Further findings
Incidence by initial rhythm
- Shockable incidence per 100 000 person-years
- 20.9
- Nonshockable incidence per 100 000 person-years
- 59.8
- Shockable 2001 vs 2020
- 28.6 vs 17.9
- Shockable AAC
- −2.3% (−2.9% to −1.5%) (95% CI)
- Nonshockable 2001 vs 2020
- 59.8 vs 63.7
- Nonshockable AAC
- 0.3% (−0.1% to 0.8%) (95% CI)
Survival to discharge by rhythm, 2001-2005 vs 2016-2020
- Shockable
- 35% (591 of 1689) vs 47.5% (768 of 1617)
- Nonshockable
- 6.4% (265 of 4135) vs 10.1% (536 of 5323)
- Trend
- P < 0.001
Prehospital resuscitation (survival to hospital admission) and in-hospital survival
- Temporal improvement
- P < 0.001
Bystander CPR and early AED by non-EMS personnel, 2001-2005 vs 2016-2020
- Bystander cardiopulmonary resuscitation
- 55.5% vs 73.9%
- Early automated external defibrillator application by non-EMS personnel
- 2.2% vs 10.9%
- Trend
- P < 0.001
Original publication
Summarised from the published abstract; every number is checked against it