High-rise buildings and neurologically favorable outcome after out-of-hospital cardiac arrest

BackgroundThe number of people living in high-rise buildings has recently been increasing in Japan, and delayed transport time by emergency-medical-service (EMS) personnel from higher floors could lead to lower survival after out-of-hospital cardiac arrest (OHCA). However, there are no clinical studies assessing the association between the floor where patients reside and neurologically favorable outcome after OHCA.MethodsThis was a prospective, population-based study conducted in Osaka City, Japan that enrolled adults aged >=18 years suffering an OHCA of cardiac origin before EMS arrival between 2013 and 2014. The primary outcome measure was one-month survival with neurologically favorable outcome. We divided OHCA patients into the following groups: those residing on >=3 floors (the high floor group) and < 3 floors (the low floor group). Multiple logistic regression analysis was used to assess factors associated with neurologically favorable outcome.ResultsA total of 2979 patients were eligible for analysis. Of them, 1885 (62.3%) occurred below the third floor and 1094 (37.4%) occurred at or above the third floor. The proportion of neurologically favorable outcome after OHCA was significantly lower in the high floor group than in the low floor group (2.7% [30/1094] versus 4.8% [91/1885], P = 0.005). In a multivariate analysis, neurologically favorable outcome after OHCA was significantly lower in the high floor group than in the low floor group (adjusted odds ratio, 0.59 [95% confidence interval, 0.37-0.96]).ConclusionsIn this population, one-month survival with neurologically favorable outcome from OHCA was lower in the high floor group than in the low floor group.