Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Scharf, B.
A retrospective analysis of out-of-hospital cardiac arrests in Carinthia
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2024. pp.
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Kolesnik Ewald
- von Lewinski Dirk
- Altmetrics:
- Abstract:
- Background and Aims: Out-of-hospital cardiac arrest (OHCA) poses a tough medical challenge with poor survival rates. Survival depends on the timing, and quality of cardiopulmonary resuscitation (CPR) measures. Some factors associated with a favorable outcome have been defined, but regional differences do not allow a generalization. No cardiac arrest registry has been established in Austria so far. The aim of this retrospective analysis is to provide a systematic overview of OHCA events in the Austrian State of Carinthia in a contemporary setting. Material and Methods: A retrospective analysis of all medical emergencies that were classified as cardiac arrest, that occurred in Carinthia in 2018, was performed. Original protocols of air, and ground rescue operations performed by the Air Rescue Austria and the Austrian Red Cross Carinthia were evaluated. The clinical course of all OHCA patients that were transported to the hospital was followed by a retrospective analysis of the regional clinical information system. Results: A total of 441 OHCA cases were identified, of which 106 (24 %) resulted in return of spontaneous circulation (ROSC), 292 (66 %) in death preceded by CPR, and in 43 (10 %) of the patients, transport with ongoing CPR was initiated. Clinical data of 125 patients with ROSC or that arrived with ongoing CPR were accessible. Of these, 30 patients (24 %) survived with a favorable neurological outcome, two patients (2 %) had a persistent vegetative state, and 93 patients (74 %) did not survive the hospital stay. The median age of all analyzed patients was 75 years (interquartile range [IQR] 62 - 85) and 35 % were female. The median arrival time of the advanced life support (ALS) team was 10 minutes (IQR 7 - 16 minutes). In 47 % of all OHCA cases, bystander CPR was performed. Pre-hospital defibrillation (p= 0.002), younger age (p= 0.032), and shorter duration of CPR (p< 0.001) were associated with increased ROSC rates, while younger age (p= 0.012), shorter duration of CPR (p< 0.001), lower initial blood levels of lactate (p< 0.001), higher blood-pH levels (p< 0.001), and lower serum levels of the neuron-specific enolase (NSE; p= 0.031) were associated with in-hospital survival. In logistic regression, shorter duration of CPR was the strongest predictor for both, preclinical ROSC (p< 0.001) and overall survival (p= 0.033). Among blood biomarkers, lower lactate levels were a predictor of survival (p= 0.012). None of the patients transported with ongoing CPR survived. Conclusion: The overall survival rate observed in this study was 7.3 %. The ROSC rate of OHCA patients in Carinthia was approximately 24 %. Prehospital defibrillation, younger age, and shorter duration of CPR contributed to a primarily positive outcome of OHCA, whereas age, duration of CPR, and blood levels of lactate, pH, and NSE levels were associated with survival. Shorter duration of CPR was identified as the strongest predictor of survival.