In-hospital survival after out-of-hospital cardiac arrest in Carinthia, Austria

Authors

  • Bianca Scharf Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Austria; Austrian Red Cross, Landesverband Kärnten, Klagenfurt, Austria
  • Ewald Kolesnik Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Austria; Austrian Red Cross, Landesverband Kärnten, Klagenfurt, Austria https://orcid.org/0000-0002-9349-8068
  • Raffaela Planka Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Austria; Austrian Red Cross, Landesverband Kärnten, Klagenfurt, Austria.
  • Nora Schwegel Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Austria https://orcid.org/0000-0001-8736-9625
  • Hannes Alber Department of Internal Medicine and Cardiology, State Hospital Klagenfurt, Austria
  • Rudolf Likar Department of Anesthesia and Intensive Care Medicine, State Hospital Klagenfurt, Austria https://orcid.org/0000-0002-6588-5028
  • Markus Peck Department of Gastroenterology and Internal Medicine, State Hospital Klagenfurt, Austria https://orcid.org/0000-0002-0597-2728
  • Wolfgang Preiss Department of Internal Medicine, State Hospital Wolfsberg, Austria
  • Gernot Aichinger Department of Anaesthesia and Intensive Care Medicine, State Hospital Villach, Austria; Air Rescue Austria (ARA), Klagenfurt, Austria
  • Matthias Schwarz Department of Anesthesia and Intensive Care Medicine, State Hospital Klagenfurt, Austria
  • Ursula Rohrer Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Austria. https://orcid.org/0000-0001-7266-3864
  • Andreas Zirlik Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Austria https://orcid.org/0000-0001-6290-3297
  • Dirk von Lewinski Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Austria https://orcid.org/0000-0001-9996-6128
  • Christian Wankmüller Austrian Red Cross, Landesverband Kärnten, Klagenfurt, Austria; Department of Operations, Energy, and Environmental Management, University of Klagenfurt, Austria

DOI:

https://doi.org/10.31247/agnj.v2iS1.47

Keywords:

OHCA, retrospective analysis, in-hospital survival, Carinthia

Abstract

Aims of the study: The survival after an out-of-hospital cardiac arrest (OHCA) event depends on the timing and quality of cardiopulmonary resuscitation (CPR) measures. Some factors associated with a favourable outcome are defined but regional differences do not allow a generalization. This analysis reflects the situation of Carinthia, Austria.

Methods: The clinical course of all OHCA survivors of the year 2018 treated by the emergency medical services (EMS) operated by the Austrian Red Cross Carinthia and the Air Rescue Austria (ARA) was followed by a retrospective analysis of the regional clinical information system.

Results: In total, 441 OHCA events were identified, from which 149 patients were transported to a hospital. Clinical data of 125 cases was accessible. From these, 30 patients survived with a favourable neurological outcome, two patients had a persistent vegetative state, and 93 patients did not survive the hospital stay. Those patients who survived were younger (p = 0.012), received a shorter duration of CPR measures (p < 0.01), had lower blood levels of lactate (p < 0.01), higher blood pH (p < 0.01), and lower serum levels of the neuron specific enolase (NSE; p = 0.031). Factors that were not associated with survival were preclinical arrival time of the advanced life support team (p = 0.317), the presence of a bystander during the OHCA event (p = 0.415), or blood levels of oxygen (p = 0.684) or carbon dioxide (p = 0.296). None of the patients transported during CPR survived.

Conclusion: Patients who primarily survive an OHCA event show a clinical survival rate of approximately 25 % in Carinthia. Age, duration of CPR, and blood levels of lactate, pH, and NSE levels are associated with survival.

 

Total
(n = 125)

Survivors
(n = 32)

Dead
(n = 93)

p

Age [median (IQR); years]

71 (59-81)

64 (56-75)

72 (61-82)

0.012

Female sex [%]

31

25

33

0.388

Arrival time of ALS team [median (IQR); minutes]

9 (7-14)

11 (8-15)

8 (6-12)

0.317

Duration of CPR [median (IQR); minutes]

15 (9-30)

10 (2-11)

23 (10-36)

<0.001

Bystander-CPR [%]

47

53

45

0.415

Transport during CPR [n]

28

0

28

-

Blood lactate levels [median (IQR); mmol/l]

7.4 (4.1-12.5)

3.3 (2.3-5.8)

9.9 (5.9-13.7)

<0.001

Blood pH level [median (IQR)]

7.1 (7.0-7.2)

7.3 (7.1-7.3)

7.1 (7.0-7.2)

<0.001

Blood arterial oxygen level [median (IQR); mmHg]

102 (64-173)

107 (62-185)

97 (65-173)

0.684

Blood arterial carbon dioxide level [median (IQR); mmHg]

55 (44-68)

50 (43-66)

57 (45-69)

0.296

Blood neuron specific enolase level [median (IQR); µg/l]

48 (29-95)

22 (17-60)

54 (33-112)

0.031

ECMO use [n]

4

0

4

-

Induced hypothermia [%]

44

44

44

0.107

Suspected primary cause of OHCA

 

Thromboembolic event [%]

29

44

24

 

Hypoxia [%]

20

34

15

 

Hypo- / Hyperkalemia [%]

2

3

1

 

Hypovolemia [%]

0.8

0

1

 

Pneumothorax [%]

0.8

0

1

 

Intoxication [%]

0.8

0

1

 

Malign arrhythmia [%]

6

19

2

 

Unknown [%]

51

0

54

 

Published

2024-04-04

How to Cite

In-hospital survival after out-of-hospital cardiac arrest in Carinthia, Austria. (2024). AGN Journal, 2(S1). https://doi.org/10.31247/agnj.v2iS1.47

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