Measuring survival rates from sudden cardiac arrest: the elusive definition

Resuscitation
Michael R SayrePAD Investigators

Abstract

Measuring survival from sudden out-of-hospital cardiac arrest (OOH-CA) is often used as a benchmark of the quality of a community's emergency medical service (EMS) system. The definition of OOH-CA survival rates depends both upon the numerator (surviving cases) and the denominator (all cases). The purpose of the public access defibrillation (PAD) trial was to measure the impact on survival of adding an automated external defibrillator (AED) to a volunteer response system trained in CPR. This paper reports the definition of OOH-CA developed by the PAD trial investigators, and it evaluates alternative statistical methods used to assess differences in reported "survival." Case surveillance was limited to the prospectively determined geographic boundaries of the participating trial units. The numerator in calculating a survival rate should include only those patients who survived an event but who otherwise would have died except for the application of some facet of emergency medical care-in this trial a defibrillatory shock. Among denominators considered were: total population of the study unit, all deaths within the study unit, and documented ventricular fibrillation cardiac arrests. The PAD classification focused upon cases that ...Continue Reading

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Citations

Jun 2, 2005·Current Opinion in Critical Care·Jason Begue, Thomas Terndrup
Aug 13, 2004·The New England Journal of Medicine·A P HallstromUNKNOWN Public Access Defibrillation Trial Investigators
Nov 24, 2011·Emergency Medicine Clinics of North America·Dawn TaniguchiGraham Nichol
Mar 27, 2009·Annals of Emergency Medicine·Graham NicholUNKNOWN PAD Investigators
Nov 3, 2007·The Journal of Emergency Medicine·Samuel J StrattonUNKNOWN Los Angeles County Prehospital Care Coordinators

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