Epidemiology and outcomes of out-of-hospital cardiac arrest in Rochester, New York

SummaryObjectiveTo characterize out-of-hospital cardiac arrest (OHCA) and factors that affect survival in a medium sized city that uses system status management for dispatch.MethodsA retrospective cohort study of all adult OHCA patients treated by EMS between 1998 and 2001 was conducted using Utstein definitions. The primary endpoint was 1-year survival.ResultsOf the 1177 patients who experienced OHCA during the study period, 539 (46%) met inclusion criteria. Age ranged from 18 to 98 years (median 67). The median call-response interval was 5 min (range 0–21), and 93% were 9 min or less. There was no significant difference in the median call-response intervals between call location zip (Post) codes (p = 0.07). Twenty percent of experienced ROSC (95% CI 17–23), 7% survived more than 30 days (95% CI 5–9%), and 5% survived to 1 year (95% CI 3–7%). In bivariate analysis, first rhythm and bystander CPR affected survival to 1 year. There was no significant difference in survival between male (4%) and female (7%), black (4%) and white (6%), or witnessed (7%) and unwitnessed arrest (4%). Logistic regression identified younger age, CPR initiated by bystander (19%) or first responder (41%), and presenting rhythm of VF/VT (32%) as factors associated with survival to 1 year.ConclusionsThis study finds a 5% survival to 1 year among OHCA patients in Rochester, NY. A presenting rhythm of VF/VT and bystander CPR were associated with increased survival.