The analysis shows only 7.6 percent of victims survive an out-of-hospital cardiac arrest, a number that has not changed significantly in almost 30 years. Physicians report that there are some key factors that can make a difference in saving lives when cardiac arrest happens at home, a hotel, restaurant or workplace.
“Our study shows that patients with a heart rhythm that can be shocked, or who have bystander cardiopulmonary resuscitation, or a pulse restored at the scene have a much greater chance of survival,” says lead author Comilla Sasson. Although half of cardiac arrests are witnessed by a bystander, according to the study, only 32 percent is receiving bystander cardiopulmonary resuscitation (CPR).
Researchers evaluated data on 142,740 patients from 79 studies published internationally between January 1950 and August 2008. And this is what they found:
- Of the more than 140,000 patients, only 23.8 percent survived to hospital admission, and 7.6 percent, or about one in ten people, lived to be discharged from the hospital.
- Cardiac arrest victims who received CPR from a bystander or an emergency medical services provider, and those who had a shockable heart rhythm, referred to as ventricular fibrillation, were more likely to survive.
- The strongest predictor of survival was a return of spontaneous circulation, meaning a pulse was restored at the scene. Among them, 15.5 percent (in low-performing EMS systems) to 33.6 percent (in high performing EMS systems) survived.
"Increasing bystander CPR rates, increasing the awareness and use of devices to shock the heart, and keeping paramedics on scene until they restore a person’s pulse needs to occur if we are ever going to change our dismal survival rate,” Sasson says.
The lack of progress in survival across the U.S. and abroad may be linked to an aging population, a lower number of people who are found in a shockable rhythm, which is associated with the highest chance of survival, and longer emergency medical service drives due to the increasing size of cities and traffic congestion, authors write.
MEDICA.de; Source: University of Michigan Health System