Clinical InvestigationAcute Ischemic Heart DiseaseOutcome after out-of-hospital cardiac arrest in a physician-staffed emergency medical system according to the Utstein style
Section snippets
Patients and methods
This study included all patients who had an OHCA in whom resuscitation was attempted by the Dachau ALS services between January 2000 and January 2006. Pediatric patients were included in the study. The Dachau EMS system serves the city of Dachau, a midsized urban community and its suburban environs covering a population of approximately 134,019 residents in a region of 580 km2. At the time of the study, 48.7% of the residents were male, and 10.6% of residents were ≥70 years of age.
Results
Within a 6-year period, 814 patients that had cardiac arrest were covered by the Dachau ALS services. In 275 of these patients, CPR was not attempted because death was confirmed by postmortem lividity and rigor mortis or because cardiac arrest had obviously occurred after end-stage malignant or other severe chronic disease (Figure 1, A). In 539 patients (349 males, 64.7%; mean age, 63.9 ± 19.1 years; range, 0.1-94.1 years), CPR was initiated. In 149 (27.6%) patients, a defibrillation attempt
Discussion
In a midsized urban/suburban system with 2-tier ALS services, in which the ALS is provided by physicians, 11.4% of patients resuscitated after a cardiac arrest of cardiac etiology were discharged alive. Most of these patients showed good neurological outcome. Several factors influencing outcome could be identified. Factors such as witnessed cardiac arrest, VF in the first recorded ECG, or shorter response time intervals (<8 minutes) were associated with higher survival rates at the time of
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