The Korean Journal of Emergency Medical Services (한국응급구조학회지)

The Korea Society of Emergency Medical Services (한국응급구조학회)
권호 표지
DOI QR코드

DOI QR Code

Determinants on survival outcomes of sudden out-of-hospital cardiac arrest: a multilevel analysis

병원 밖에서 발생한 급성 심장정지 환자의 생존결과에 영향을 미치는 요인 : 다수준 분석

  • Kim, Hyo-Sil (Department of Health Administration, Cheju Halla University) ;
  • Chun, Jin-Ho (Department of Preventive Medicine, College of Medicine, Inje University)
  • 김효실 (제주한라대학교 보건행정과) ;
  • 전진호 (인제대학교 의과대학 예방의학교실)
  • Received : 2020.07.13
  • Accepted : 2020.08.14
  • Published : 2020.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study aimed to identify the factors affecting the survival outcomes of out-of-hospital cardiac arrest based on the Sudden Cardiac Arrest Survey by the Korean Centers for Disease Control and Prevention from 2012 to 2016. Methods: Out of 84,776 cases, 57,104 cases of cardiac arrest were analyzed. To identify the factors that affect survival outcomes after a sudden cardiac arrest (SCA), we performed a logistic regression using SPSS. We also performed a multilevel analysis using SAS to determine whether the survival outcomes were affected by the socioeconomic level and health index of the communities. Results: When SCA was witnessed by someone, the possibility of discharge with survival outcomes increased by a factor of 4.54. If CPR was administered immediately in emergency situations, this possibility further increased. When defibrillation was performed before hospitalization, the possibility was increased by a factor of 10.31. The multilevel analysis reflected the personal and regional factors that had an impact on the survival outcomes. Conclusion: Because the initial response in SCA is crucial, a community response system is essential before hospitalization. It is necessary to actively publicize and educate the people because the their understanding, sympathy, and cooperation in emergency situations play a role in determining the survival outcomes of the patients.

Keywords

References

  1. McNally B, Robb R, Mehta M, Vellano K, Valderrama AL, Yoon PW et al. Out-of-hospital cardiac arrest surveillance - Cardiac Arrest Registry to Enhance Survival (CARES), United States. MMWR Surveill Summ 2011;60(SS08):1-19.
  2. Hasegawa K, Tsugawa Y, Camargo CA, Hiraide A, Brown DFM. Regional variability in survival outcomes of out-of-hospital cardiac arrest: the All-Japan Utstein Registry. Resuscitation 2013;84(8):1099-107. https://doi.org/10.1016/j.resuscitation.2013.03.007
  3. Min YG. Treatment of cardiac arrest patients. J Kor Soc Health-Syst Pharm 2012;29(2):121-5.
  4. Out-of-hospital cardiac arrest surveillance. Korea Centers for Disease Control and Prevention. 2006-2016.
  5. Jeong SY, Kim CW, Yoon TH, Kim YJ, Hong SO, Choi JA. The Factors influencing neurological outcome of out-of-hospital cardiac arrest with cardiac etiology. J Korean Soc Emerg Med 2016;27(2):165-72.
  6. Buick JE, Drennan IR, Scales DC, Brooks SC, Byers A, Cheskes S et al. Improving temporal trends in survival and neurological outcomes after out-of-hospital cardiac arrest. Circulation: Cardiovascular Quality and Outcomes 2018;11(1):e003561. https://doi.org/10.1161/CIRCOUTCOMES.117.003561
  7. Rea TD, Helbock M, Perry S, Garcia M, Cloyd D, Becker L et al. Increasing use of cardiopulmonary resuscitation during out-ofhospital ventricular fibrillation arrest: survival implications of guideline changes. Circulation 2006;114(25):2760-5. https://doi.org/10.1161/CIRCULATIONAHA.106.654715
  8. Ro YS. Out-of-hospital cardiac arrest in Korea: who does survive?. Unpublished doctoral dissertation, Seoul National University 2014, Seoul, Korea.
  9. Ong MEH, Shin SD, DeSouza NNA, Tanaka H, Nishiuchi T, Song KJ et al. Outcomes for out-of-hospital cardiac arrests across 7 countries in Asia: The Pan Asian Resuscitation Outcomes Study(PAROS). Resuscitation 2015;96:100-8. https://doi.org/10.1016/j.resuscitation.2015.07.026
  10. Guidelines for using raw data for sudden cardiac arrest investigation. KCDC. 2012-2016.
  11. Local Financial Yearbook. Ministry of Government Administration and Home Affairs. 2012, 2014, 2016.
  12. Health insurance statistics. National Health Service. 2012, 2014, 2016.
  13. Jeong SY, Kim CW, Hong SO. The factors influencing survival of out-of-hospital cardiac arrest with cardiac etiology. Journal of the Korea Academia-Industrial cooperation Society 2016;17(2):560-9. https://doi.org/10.5762/KAIS.2016.17.2.560
  14. Shin SS, Shin YJ. A multilevel analysis of influential factors on suicidal ideation. J of Critical Social Policy 2014;45:230-66.
  15. Shin SS, Woo KS, Shin YJ. Systematic review of studies on public health using multilevel analysis: focused on research trends and the assessment of risk of bias. Health and Social Welfare Review 2015;35(4):157-89. https://doi.org/10.15709/hswr.2015.35.4.157
  16. Park HJ. Analysis on walking practice of the elderly considering local effect in the big cities. Unpublished master's thesis, Seoul National University 2016, Seoul, Korea.
  17. Stiell IG, Wells GA, Field B, Spaite DW, Nesbitt LP, De Maio VJ et al. Advanced cardiac life support in out-of-hospital cardiac arrest. N Eng J Med 2004;351:647-56. https://doi.org/10.1056/NEJMoa040325
  18. Spaite DW, Stiell IG, Bobrow BJ, De Boer M, Maloney J, Denninghoff K et al. Effect of transport interval on out-of-hospital cardiac arrest survival in the OPALS study: implications for triaging patients to specialized cardiac arrest centers. Ann Emerg Med 2009;54(2):248-55. https://doi. org/10.1016/j.annemergmed.2008.11.020
  19. Weston CFM, Wilson RJ, Jones SD. Predicting survival from out-of-hospital cardiac arrest: a multivariate analysis. Resuscitation 1997;34(1):27-34. https://doi.org/10.1016/s0300-9572(96)01031-3
  20. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB et al. Heart disease and stroke statistics-2013 update. Circulation 2013;127(1):143-52. http://doi.org/10.1161/CIR.0b013e318282ab8f
  21. Larsen MP, Eisenberg MS, Cummins RO, Hallstrom AP. Predicting survival from out-of-hospital cardiac arrest: a graphic model. Ann Emerg Med 1993;22(11):1652-8. https://doi.org/10.1016/s0196-0644(05)81302-2
  22. Atwood C, Eisenberg MS, Herlitz J, Rea TD. Incidence of EMS-treated out-of-hospital cardiac arrest in Europe. Resuscitation 2005;67(1):75-80. https://doi.org/10.1016/j.resuscitation.2005.03.021
  23. Hollenberg J, Herlitz J, Lindqvist J, Riva G, Bohm K, Rosenqvist M et al. Improved survival after out-of-hospital cardiac arrest is associated with an increase in proportion of emergency crew-witnessed cases and bystander cardiopulmonary resuscitation. Circulation 2008;118(4):389-96. https://doi.org/10.1161/CIRCULATIONAHA.107.734137
  24. Vaillancourt C, Lui A, De Maio VJ, Wells GA, Stiell IG. Socioeconomic status influences bystander CPR and survival rate for out-of-hospital cardiac arrest victims. Resuscitation 2008;79(3):417-23. https://doi.org/10.1016/j.resuscitation.2008.07.012
  25. Dahan B, Jabre P, Karam N, Misslin R, Tafflet M. Impact of neighbourhood socio-economic status on bystander cardiopulmonary resuscitation in Paris. Resuscitation 2017;110:107-13. https://doi.org/10.1016/j.resuscitation.2016.10.028