Factors associated with sustained prehospital return of spontaneous circulation after out-of-hospital cardiac arrest at Nakornping Hospital
Keywords:
out-of-hospital cardiac arrest, prehospital return of spontaneous circulation, emergency medical services, predictive factors, cardiopulmonary resuscitationAbstract
Introduction: Out-of-hospital cardiac arrest (OHCA) is an emergency medical condition, which needs advanced cardiac life support. However, there has been a lack of consensus to determine the factors related to the outcome.
Objectives: This study aimed to identify the factors associated with sustained prehospital return of spontaneous circulation (sustained PROSC) after OHCA.
Methods: This is a retrospective prognostic study conducted at Nakornping Hospital. Data were collected from the medical records of OHCA patients between January 1, 2020, and December 31, 2023. The inclusion criteria were patients aged 18 years or older who experienced out-of-hospital cardiac arrest, were transported by advanced medical response units, and were later admitted to the emergency department. The exclusion criteria included patients with a do-not-attempt-resuscitation (DNAR) order, individuals whose cardiac arrest resulted from trauma, those who received emergency medical care via air transport (sky doctor), patients showing post-mortem changes from the outset, and individuals treated in the emergency departments of other hospitals. Factors associated with sustained PROSC following OHCA were analyzed using logistic regression. Data analysis was performed using descriptive and logistic regression analysis.
Results: A total of 266 patients were included in the study. The participants had an average age of 64.1 ± 16.9 years. There were 104 patients (39.1%) who had sustained PROSC. Mean response time was 13.3 ± 6.1 minutes. In multivariable analysis age over 60 years (Adjusted Odd Ratio 1.94; 95%CI: 1.05-3.56, p=0.033) and bedridden patients (Adjusted OR: 11.91; 95%CI: 2.58-54.97, p=0.002) were factors associate sustain PROSC.
Conclusion: Age over 60 years and bedridden were significantly associated with sustained PROSC after OHCA. Therefore, the emergency medical system should be adapted and developed effective protocol to handle patients experiencing OHCA and gain the success rates of resuscitation in our hospital.
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