The epidemiology of out-of-hospital cardiac arrest in Australia and New Zealand: A binational report from the Australasian Resuscitation Outcomes Consortium (Aus-ROC),Resuscitation

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The epidemiology of out-of-hospital cardiac arrest in Australia and New Zealand: A binational report from the Australasian Resuscitation Outcomes Consortium (Aus-ROC)
Resuscitation ( IF 6.5 ) Pub Date : 2022-01-22 , DOI: 10.1016/j.resuscitation.2022.01.011
Janet Bray ₁ , Stuart Howell ₂ , Stephen Ball ₃ , Tan Doan ₄ , Emma Bosley ₅ , Karen Smith ₆ , Bridget Dicker ₇ , Steven Faddy ₈ , Melanie Thorrowgood ₉ , Andy Swain ₁₀ , Andrew Thomas ₁₁ , Alexander Wilson ₁₂ , Carol Shipp ₁₃ , Tony Walker ₁₄ , Paul Bailey ₁₅ , Judith Finn ₁₆ ,

Affiliation

Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia.
Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia; St John Western Australia, Western Australia, Australia.
Queensland Ambulance Service, Queensland, Australia.
Queensland Ambulance Service, Queensland, Australia; School of Clinical Sciences, Queensland University of Technology, Queensland, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia.
St John New Zealand, Auckland, New Zealand; Auckland University of Technology, Auckland, New Zealand.
NSW Ambulance, New South Wales, Australia.
SA Ambulance Service, South Australia, Australia.
Wellington Free Ambulance, Wellington, New Zealand.
St John Ambulance NT, Northern Territory, Australia.
ACT Ambulance, Australian Capital Territory, Australia.
Ambulance Tasmania, Tasmania, Australia.
Ambulance Victoria, Victoria, Australia.
St John Western Australia, Western Australia, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia; St John Western Australia, Western Australia, Australia.

Introduction

The Australasian Resuscitation Outcomes Consortium (Aus-ROC) out-of-hospital cardiac arrest (OHCA) Epistry (Epidemiological Registry) now covers 100% of Australia and New Zealand (NZ). This study reports and compares the Utstein demographics, arrest characteristics and outcomes of OHCA patients across our region.

Methods

We included all OHCA cases throughout 2019 as submitted to the Epistry by the eight Australian and two NZ emergency medical services (EMS). We calculated crude and age-standardised incidence rates and performed a national and EMS regional comparison.

Results

We obtained data for 31,778 OHCA cases for 2019: 26,637 in Australia and 5,141 in NZ. Crude incidence was 107.9 per 100,000 person-years in Australia and 103.2/100,000 in NZ. Overall, the majority of OHCAs occurred in adults (96%), males (66%), private residences (76%), were unwitnessed (63%), of presumed medical aetiology (83%), and had an initial monitored rhythm of asystole (64%). In non-EMS-witnessed cases, 38% received bystander CPR and 2% received public defibrillation. Wide variation was seen between EMS regions for all OHCA demographics, arrest characteristics and outcomes. In patients who received an EMS-attempted resuscitation (13,664/31,778): 28% (range across EMS = 13.1% to 36.7%) had return of spontaneous circulation (ROSC) at hospital arrival and 13% (range across EMS = 9.9% to 20.7%) survived to hospital discharge/30-days. Survival in the Utstein comparator group (bystander-witnessed in shockable rhythm) varied across the EMS regions between 27.4% to 42.0%.

Conclusion

OHCA across Australia and NZ has varied incidence, characteristics and survival. Understanding the variation in survival and modifiable predictors is key to informing strategies to improve outcomes.

中文翻译：

澳大利亚和新西兰院外心脏骤停的流行病学：澳大利亚复苏结果联盟 (Aus-ROC) 的双边报告

介绍

澳大利亚复苏结果联盟 (Aus-ROC) 院外心脏骤停 (OHCA) Epistry（流行病学登记）现在覆盖了澳大利亚和新西兰 (NZ) 的 100%。本研究报告并比较了我们地区 OHCA 患者的 Utstein 人口统计、逮捕特征和结果。

方法

我们纳入了 2019 年全年所有 OHCA 病例，这些病例由八个澳大利亚和两个新西兰紧急医疗服务 (EMS) 提交给 Epistry。我们计算了粗略和年龄标准化的发病率，并进行了全国和 EMS 区域比较。

结果

我们获得了 2019 年 31,778 例 OHCA 病例的数据：澳大利亚为 26,637 例，新西兰为 5,141 例。澳大利亚的粗发病率为每 10 万人年 107.9 人，新西兰为每 10 万人年 103.2 人。总体而言，大多数 OHCA 发生在成人 (96%)、男性 (66%)、私人住宅 (76%)、没有目击者 (63%)、假定的医学病因 (83%)，并且最初监测的节律为心搏停止 (64%)。在非 EMS 目击病例中，38% 接受了旁观者心肺复苏术，2% 接受了公共除颤。对于所有 OHCA 人口统计、逮捕特征和结果，EMS 地区之间存在很大差异。在接受 EMS 尝试复苏的患者中 (13,664/31,778)：28%（EMS 范围 = 13.1% 至 36.7%）在到达医院时自主循环 (ROSC) 恢复，13%（EMS 范围 = 9.9% 至20.7%) 存活至出院/30 天。