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Original Research

Open Access

Major interventions are associated with survival of out of hospital cardiac arrest patients - a population based survey

  • Yi-Chuan Chen1,2
  • Ming-Szu Hung3,4
  • Chia-Hao Chang2,5
  • Chia-Yen Liu'6
  • Pau-Chung Chen7
  • Cheng-Ting Hsiao1,4
  • Yao-Hsu Yang6,8,9

1Department of Emergency Medicine, Chang Gung Memorial Hospital, Puzih City, Taiwan

2 Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan

3 Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Puzih City, Taiwan

4 Chang Gung University College of Medicine, Gueishan Township, Taiwan

5 College of Nursing & the Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi, Taiwan

6 Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan

7 Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan

8 Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan

9 School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan

DOI: 10.22514/SV132.112017.17 Vol.13,Issue 2,November 2017 pp.108-115

Published: 06 November 2017

*Corresponding Author(s): Yao-Hsu Yang E-mail: r95841012@ntu.edu.tw

Abstract

Background. The overall survival rate of out-of-hospital cardiac arrest (OHCA) in Taiwan or even in the whole of Asia is relatively low. Major interventions, such as target temperature management (TTM), coronary artery angiography, and extracorporeal membrane oxygenation (ECMO), have been associated with better patient outcome. However, studies in Tai-wan revealing evidence of the benefits of these interventions are limited. Methods. A population-based study used an 8-year database to analyze overall sur-vival and risk factors ˝among OHCA pa-tients. All adult non-trauma OHCA pa-tients were identified through diagnostic and procedure codes. Hospital survival and return of spontaneous circulation (ROSC) were primary and secondary out-comes. Logistic regression and Cox regres-sion analyses were conducted.

Results. There was a relationship between major interventions (including TTM, coronary artery angiography, and ECMO) and better hospital survival. Age, income, major interventions, and acute myocardial infarction history were associated with hospital survival. The adjusted hazard ratios (HRs) were 0.406 (95% CI, 0.295 to 0.558), 1.109 (95% CI, 1.027 to 1.197), 1.075 (95% CI, 1.002 to 1.154), 1.097 (95% CI, 1.02 to 1.181) and 0.799(95% CI, 0.677 to 0.942) for patients with major interventions, age≥50, medium low and low in-come, middle income, and acute myocar-dial infarction history, respectively. Conclusion. This population-based study in Taiwan revealed that older age (≥50), medium low and low income were associ-ated with a lower rate of survival. Major interventions, including TTM, coronary angiography, and ECMO, were related to better survival.


Keywords

OHCA, ROSC, out-of-hospital cardiac arrest, target temperature manage-ment, ECMO

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Yi-Chuan Chen,Ming-Szu Hung,Chia-Hao Chang,Chia-Yen Liu',Pau-Chung Chen,Cheng-Ting Hsiao,Yao-Hsu Yang. Major interventions are associated with survival of out of hospital cardiac arrest patients - a population based survey. Signa Vitae. 2017. 13(2);108-115.

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