Epidemiology and outcomes of out-of-hospital cardiac arrest in Zhejiang, China based on Electronic Medical Record Surveillance

Abstract

Background

Out-of-hospital cardiac arrest (OHCA) is a critical challenge for public health, with wide variation in epidemiology and outcomes in different countries and regions. We aimed to describe the epidemiology and outcomes for OHCA in Zhejiang, China based on Electronic Medical Record Surveillance.

Methods

This retrospective study using the Zhejiang Emergency Command Center Electronic Medical Record System in Zhejiang Province, China. We included OHCA cases with non-traumatic, aged 18 years and above and had resuscitation attempted by emergency medical services (EMS). All data were collected and reported using the Utstein template. The primary outcomes were survival to discharge or 30th day, the secondary outcomes were survival with favorable neurological outcomes.

Results

6923 non-traumatic OHCA patients with aged 18 and above were identified. The OHCA incidence assessed by EMS was 37.6 per 100,000 population. The median age was 68 (54–79) years, with more than half of patients aged 65 or older. 4860 (70.2%) were male, 5033 (72.7%) had cardiac arrest at home. 2889 (41.7%) patients had bystander cardiopulmonary resuscitation (CPR). Among 6923 non-traumatic, 608 (8.8%) patients had shockable rhythm, 497 (7.2%) patients achieved return of spontaneous circulation (ROSC), 82 (1.2%) patients survived to hospital discharge. Under 65 years of age who received bystander CPR, 173 (12.1%) patients achieved ROSC, 43 (3.0%) patients survived to hospital discharge.

Conclusion

The survival after OHCA in Zhejiang Province is unsatisfactory, especially for those above 65 years patients. Electronic Medical Record Surveillance can assist the implementation of the chain of survival to improve outcomes.