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General characteristics out of hospital cardiac arrest of cardiac origin recorded by an emergency medical service

López-Messa JB, Alonso-Fernández JI, Andrés De Llano JM, Garmendia-Leiza JR, Ardura-Fernández J, De Castro-Rodríguez F, Gil-González JM

Servicio de Medicina Intensiva. Complejo Asistencial de Palencia, Spain. Grupo de Investigación Reconocido de Cronobiología. Universidad de Valladolid, Spain. Servicio de Emergencias Sanitarias de Castilla y León, Spain.

Objective: To analyze the general characteristics out of prehospital cardiac arrest
(OHCA) including the frecuency of return of spontaneous circulation and related factors.
Methods: Retrospective descriptive analysis of cases of OHCA in the records of the
emergency medical service of Castile-Leon covering a period of 18 months. The main
independent outcome analyzed was return of spontaneous circulation. Independent
variables analyzed were age, sex, presence of shockable rhythm, location of cardiac
arrest, witness, time between emergency call and initiation of care, and time between
ambulance dispatch and initiation of care.
Results: The EMS attended a total of 1286 cases of OHCA, representing an annual
incidence of 0.34 cases per 1000 population. The median age (interquartile range) was
73.0 (21.0) years; 66.5% of the patients were men, spontaneous circulation returned in
22.2%, and a shockable rhythm was present in 15.3%. Cardiac arrest occurred in the
home in 72.2% of the cases, in a public place in 21.3%, and at a primary health care
clinic in 6.5%. Witnesses were a family member (49.1%), a passer-by (31.6%), a
member of a security force (2.6%), and a primary care staff member (15.7%).
Independent variables related to return of spontaneous circulation were age under 50
years (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.03-2.4), presence of a
shockable rhythm (OR, 3.8; 95% CI, 2.7-5.3); cardiac arrest at a primary health care
clinic (OR, 2.7; 95% CI, 1.4-4.9) or in a public place (OR, 1.8; 95% CI, 1.2-2.7).
Conclusions: The incidence of OHCA was similar to that reported for other European
series. The low percentage of shockable rhythm was noteworthy. The home was
confirmed as the most common setting for cardiac arrest; lower age, presence of
shockable rhythm, occurrence of cardiac arrest in a public place or at a primary care
clinic were confirmed as variables independently associated with return of spontaneous

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