The Outcomes of the Out-of-Hospital Cardiac Arrest: A collaborative research of three hospitals

ABSTRACT

BACKGROUND: There has been a lot of changes in prehospital medical environment with development of EMSS(emergency medical service systems). Especially in out-of-hospital cardiac arrest, the patients could survive when they are moved to the hospitals earlier. The purpose of this research is to know the status of EMSS in Korea by analyzing CPR(cardiopulmonary resuscitation) outcomes of out-of-hospital cardiac arrest patients at 3 hospital in the western area of Seoul and Incheon. METHODS: From July 1997 to June 1998, we collected data about out-of-hospital cardiac arrest victims at Ewha Womens University Mokdong Hospital, Catholic University Medical College St. Mary Hospital, and Kachon University Chung Ang Gil Hospital. We used same record form based on the 'Utstein Style'. RESULTS: CPR were performed in 265 out-of-hospital cardiac arrest patients at 3 hospitals. One hundred twelve(42.3%) patients recovered the spontaneous circulation at least once and eight(3.0%) patients discharged alive. One hundred ninety four(73.2%) patients died of medical causes, one hundred two(38.5%) cardiogenic and ninety two(34.7%) non-cardiogenic, and seventy(26.4%) patients died of traumatic causes. Initial EKG showed VT/VF(ventricular tachycardia/ventricular fibrillation) in thirty one(11.7%) patients, asystole in one hundred fifty one(57.0%) patients and other rhythms in eighty three(31.3%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. CONCLUSION: Overall survival rate of out-of-hospital cardiac angst patients was 3% which was poorer than that of the western country. The proportion of the cardiogenic cause was 3% which was only hart of the western country. VT/VF is relatively not common as a initial EKG rhythm. These differences might be due to difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS.