Predictors of survival and hospital outcome of prehospital cardiac arrest in southern Taiwan

Ming-Yuan Chang, Mike Lin
Journal of the Formosan Medical Association 2005, 104 (9): 639-46

BACKGROUND AND PURPOSE: Despite recent improvements in emergency care medicine, outcome for prehospital cardiac arrest patients remains poor in southern Taiwan due to lack of training and authorization of emergency medical technicians to perform advanced life support. The purpose of this study was to analyze the characteristics of these patients and to identify possible predictive factors for final hospital discharge.

METHODS: We retrospectively reviewed the characteristics of 361 prehospital cardiac arrest patients (male:female, 226:135; median age, 69 years) undergoing cardiopulmonary resuscitation (CPR) on arrival at the emergency department (ED) between January 1, 2001 and December 31, 2003. Multivariate analysis was performed by fitting explanatory variables into logistic regression models with respect to the outcomes of admission and to hospital discharge.

RESULTS: The overall survival rate was 21.1% (n = 76) to hospital admission and 7.2% (26) to hospital discharge. About half (54%) of the 26 patients who survived had cardiac disease. Only 3 patients received CPR from a bystander, and 2 of them survived. None of the patients received electrical defibrillation before arriving at hospital because emergency personnel were not authorized to perform advanced cardiac life support (ACLS) in Southern Taiwan during the study period. Factors that predicted survival to hospital discharge included a short interval between the cardiac arrest and arrival at the ED, initial rhythm of ventricular tachycardia/ventricular fibrillation (VT/VF), lower atropine dose, higher level of hemoglobin, less multiple organ failure, and shorter duration of resuscitation in the ED. Nine of the 32 patients (28%) with VT/VF survived compared with 5 of 49 (10%) with pulseless electrical activity and only 12 of 231 (5%) with asystole. No patients who required resuscitation for longer than 20 minutes in the ED survived to hospital discharge.

CONCLUSION: The results of this study illustrate that patients with VT/VF have good potential for successful resuscitation. Prompt resuscitation and easy access for ACLS are the key factors for success. Survival rates are likely to improve if more lay people perform CPR and if emergency unit personnel are trained and allowed to perform ACLS.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"