Epidemiology and outcomes from out-of-hospital cardiac arrests in England

Claire Hawkes; Scott Booth; Chen Ji; Samantha J. Brace-McDonnell; Andrew Whittington; James Mapstone; Matthew W. Cooke; Charles D. Deakin; Chris P. Gale; Rachael Fothergill; Jerry P. Nolan; Nigel Rees; Jasmeet Soar; A. Niroshan Siriwardena; Terry P. Brown; Gavin D. Perkins

doi:10.1016/j.resuscitation.2016.10.030

Epidemiology and outcomes from out-of-hospital cardiac arrests in England

Claire Hawkes, Scott Booth, Chen Ji, Samantha J. Brace-McDonnell, Andrew Whittington, James Mapstone, Matthew W. Cooke, Charles D. Deakin, Chris P. Gale, Rachael Fothergill, Jerry P. Nolan, Nigel Rees, Jasmeet Soar, A. Niroshan Siriwardena, Terry P. Brown, Gavin D. Perkins^*

^*Corresponding author for this work

Bristol Medical School (THS)

Research output: Contribution to journal › Article (Academic Journal) › peer-review

241 Citations (Scopus)

Abstract

Introduction This study reports the epidemiology and outcomes from out-of-hospital cardiac arrest (OHCA) in England during 2014. Methods Prospective observational study from the national OHCA registry. The incidence, demographic and outcomes of patients who were treated for an OHCA between 1st January 2014 and 31st December 2014 in 10 English ambulance service (EMS) regions, serving a population of almost 54 million, are reported in accordance with Utstein recommendations. Results 28,729 OHCA cases of EMS treated cardiac arrests were reported (53 per 100,000 of resident population). The mean age was 68.6 (SD = 19.6) years and 41.3% were female. Most (83%) occurred in a place of residence, 52.7% were witnessed by either the EMS or a bystander. In non-EMS witnessed cases, 55.2% received bystander CPR whilst public access defibrillation was used rarely (2.3%). Cardiac aetiology was the leading cause of cardiac arrest (60.9%). The initial rhythm was asystole in 42.4% of all cases and was shockable (VF or pVT) in 20.6%. Return of spontaneous circulation at hospital transfer was evident in 25.8% (n = 6302) and survival to hospital discharge was 7.9%. Conclusion Cardiac arrest is an important cause of death in England. With less than one in ten patients surviving, there is scope to improve outcomes. Survival rates were highest amongst those who received bystander CPR and public access defibrillation.

Original language	English
Pages (from-to)	133-140
Number of pages	8
Journal	Resuscitation
Volume	110
DOIs	https://doi.org/10.1016/j.resuscitation.2016.10.030
Publication status	Published - 1 Jan 2017

Bibliographical note

Funding Information:
The study is supported by research grants from the British Heart Foundation and Resuscitation Council (UK). Gavin Perkins is supported as NIHR Senior Investigator and Director of Research for the Intensive Care Foundation. Samantha Brace-McDonnell is supported by a NIHR Clinical Doctoral Fellowship.

Funding Information:
Andrew Whittington reports grants from the British Heart Foundation, personal fees from West Midlands Ambulance Service Foundation Trust, outside the submitted work.

Funding Information:
Claire Hawkes, Scott Booth, Chen Ji, Samantha Brace-McDonnell, Terry Brown and Gavin Perkins are employed by the University of Warwick, which receives grants from the British Heart Foundation and the Resuscitation Council (UK) for the conduct of the OHCAO project.

Publisher Copyright:
© 2016

Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.

Keywords

Cardiac arrest
Emergency medical services
Out-of-hospital cardiac arrest
Pre-hospital care
Resuscitation

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Hawkes, C., Booth, S., Ji, C., Brace-McDonnell, S. J., Whittington, A., Mapstone, J., Cooke, M. W., Deakin, C. D., Gale, C. P., Fothergill, R., Nolan, J. P., Rees, N., Soar, J., Siriwardena, A. N., Brown, T. P., & Perkins, G. D. (2017). Epidemiology and outcomes from out-of-hospital cardiac arrests in England. Resuscitation, 110, 133-140. https://doi.org/10.1016/j.resuscitation.2016.10.030

@article{8c2de89b531640b2acf7b7456cc8bc29,

title = "Epidemiology and outcomes from out-of-hospital cardiac arrests in England",

abstract = "Introduction This study reports the epidemiology and outcomes from out-of-hospital cardiac arrest (OHCA) in England during 2014. Methods Prospective observational study from the national OHCA registry. The incidence, demographic and outcomes of patients who were treated for an OHCA between 1st January 2014 and 31st December 2014 in 10 English ambulance service (EMS) regions, serving a population of almost 54 million, are reported in accordance with Utstein recommendations. Results 28,729 OHCA cases of EMS treated cardiac arrests were reported (53 per 100,000 of resident population). The mean age was 68.6 (SD = 19.6) years and 41.3% were female. Most (83%) occurred in a place of residence, 52.7% were witnessed by either the EMS or a bystander. In non-EMS witnessed cases, 55.2% received bystander CPR whilst public access defibrillation was used rarely (2.3%). Cardiac aetiology was the leading cause of cardiac arrest (60.9%). The initial rhythm was asystole in 42.4% of all cases and was shockable (VF or pVT) in 20.6%. Return of spontaneous circulation at hospital transfer was evident in 25.8% (n = 6302) and survival to hospital discharge was 7.9%. Conclusion Cardiac arrest is an important cause of death in England. With less than one in ten patients surviving, there is scope to improve outcomes. Survival rates were highest amongst those who received bystander CPR and public access defibrillation.",

keywords = "Cardiac arrest, Emergency medical services, Out-of-hospital cardiac arrest, Pre-hospital care, Resuscitation",

author = "Claire Hawkes and Scott Booth and Chen Ji and Brace-McDonnell, {Samantha J.} and Andrew Whittington and James Mapstone and Cooke, {Matthew W.} and Deakin, {Charles D.} and Gale, {Chris P.} and Rachael Fothergill and Nolan, {Jerry P.} and Nigel Rees and Jasmeet Soar and Siriwardena, {A. Niroshan} and Brown, {Terry P.} and Perkins, {Gavin D.}",

note = "Funding Information: The study is supported by research grants from the British Heart Foundation and Resuscitation Council (UK). Gavin Perkins is supported as NIHR Senior Investigator and Director of Research for the Intensive Care Foundation. Samantha Brace-McDonnell is supported by a NIHR Clinical Doctoral Fellowship. Funding Information: Andrew Whittington reports grants from the British Heart Foundation, personal fees from West Midlands Ambulance Service Foundation Trust, outside the submitted work. Funding Information: Claire Hawkes, Scott Booth, Chen Ji, Samantha Brace-McDonnell, Terry Brown and Gavin Perkins are employed by the University of Warwick, which receives grants from the British Heart Foundation and the Resuscitation Council (UK) for the conduct of the OHCAO project. Publisher Copyright: {\textcopyright} 2016 Copyright: Copyright 2018 Elsevier B.V., All rights reserved.",

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AU - Hawkes, Claire

AU - Booth, Scott

AU - Ji, Chen

AU - Brace-McDonnell, Samantha J.

AU - Whittington, Andrew

AU - Mapstone, James

AU - Cooke, Matthew W.

AU - Deakin, Charles D.

AU - Gale, Chris P.

AU - Fothergill, Rachael

AU - Nolan, Jerry P.

AU - Rees, Nigel

AU - Soar, Jasmeet

AU - Siriwardena, A. Niroshan

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AU - Perkins, Gavin D.

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PY - 2017/1/1

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N2 - Introduction This study reports the epidemiology and outcomes from out-of-hospital cardiac arrest (OHCA) in England during 2014. Methods Prospective observational study from the national OHCA registry. The incidence, demographic and outcomes of patients who were treated for an OHCA between 1st January 2014 and 31st December 2014 in 10 English ambulance service (EMS) regions, serving a population of almost 54 million, are reported in accordance with Utstein recommendations. Results 28,729 OHCA cases of EMS treated cardiac arrests were reported (53 per 100,000 of resident population). The mean age was 68.6 (SD = 19.6) years and 41.3% were female. Most (83%) occurred in a place of residence, 52.7% were witnessed by either the EMS or a bystander. In non-EMS witnessed cases, 55.2% received bystander CPR whilst public access defibrillation was used rarely (2.3%). Cardiac aetiology was the leading cause of cardiac arrest (60.9%). The initial rhythm was asystole in 42.4% of all cases and was shockable (VF or pVT) in 20.6%. Return of spontaneous circulation at hospital transfer was evident in 25.8% (n = 6302) and survival to hospital discharge was 7.9%. Conclusion Cardiac arrest is an important cause of death in England. With less than one in ten patients surviving, there is scope to improve outcomes. Survival rates were highest amongst those who received bystander CPR and public access defibrillation.

AB - Introduction This study reports the epidemiology and outcomes from out-of-hospital cardiac arrest (OHCA) in England during 2014. Methods Prospective observational study from the national OHCA registry. The incidence, demographic and outcomes of patients who were treated for an OHCA between 1st January 2014 and 31st December 2014 in 10 English ambulance service (EMS) regions, serving a population of almost 54 million, are reported in accordance with Utstein recommendations. Results 28,729 OHCA cases of EMS treated cardiac arrests were reported (53 per 100,000 of resident population). The mean age was 68.6 (SD = 19.6) years and 41.3% were female. Most (83%) occurred in a place of residence, 52.7% were witnessed by either the EMS or a bystander. In non-EMS witnessed cases, 55.2% received bystander CPR whilst public access defibrillation was used rarely (2.3%). Cardiac aetiology was the leading cause of cardiac arrest (60.9%). The initial rhythm was asystole in 42.4% of all cases and was shockable (VF or pVT) in 20.6%. Return of spontaneous circulation at hospital transfer was evident in 25.8% (n = 6302) and survival to hospital discharge was 7.9%. Conclusion Cardiac arrest is an important cause of death in England. With less than one in ten patients surviving, there is scope to improve outcomes. Survival rates were highest amongst those who received bystander CPR and public access defibrillation.

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KW - Emergency medical services

KW - Out-of-hospital cardiac arrest

KW - Pre-hospital care

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Epidemiology and outcomes from out-of-hospital cardiac arrests in England

Abstract

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Keywords

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