May 21, 2003

Temporal trends in sudden cardiac arrest: a 25-year emergency medical services perspective

Circulation
Thomas D ReaThomas Hearne

Abstract

Little is known about temporal trends in survival and prognostic characteristics of patients with out-of-hospital cardiac arrest treated by emergency medical services (EMS). We hypothesized that an evolving combination of beneficial and adverse factors may contribute to temporal patterns of survival. We evaluated a population-based cohort of EMS-treated adult patients with cardiac arrest (n=12 591) from 1977 to 2001 in King County, Washington. Time was grouped into an initial 5-year period and 5 successive 4-year periods. We sought to determine the potential impact of temporal changes in prognostic factors typically beyond EMS control termed "fate" factors (for example, patient age) and factors implemented by EMS termed "program" factors (programs of dispatcher-assisted cardiopulmonary resuscitation and basic life support defibrillation). Several characteristics associated with survival changed over time. Observed survival did not change over time among all patients with cardiac arrest (OR=0.98 [0.95, 1.01], trend for each successive time period) and improved over time among patients with witnessed ventricular fibrillation (OR=1.05 [1.01, 1.09]). In models that included all patients with cardiac arrest and controlled for fate f...Continue Reading

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  • Citations145

Citations

Mentioned in this Paper

Ventricular Fibrillation
Emergency Care
Incidence Studies
Survival Analysis
Logistic Regression
Basic Cardiac Life Support
Sudden Cardiac Arrest
Acute Disease
Odds Ratio
Cardiopulmonary

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