Out-of-hospital cardiac arrest across the World: First report from the International Liaison Committee on Resuscitation (ILCOR)

Tekeyuki Kiguchi; Masashi Okubo; Chika Nishiyama; Ian Maconochie; Marcus Eng Hock Ong; Karl B Kern; Myra H Wyckoff; Bryan McNally; Erika F Christensen; Ingvild Tjelmeland; Johan Herlitz; Gavin D Perkins; Scott Booth; Judith Finn; Nur Shahidah; Sang Do Shin; Bentley J Bobrow; Laurie J Morrison; Ari Salo; Enrico Baldi; Roman Burkart; Chih-Hao Lin; Xavier Jouven; Jasmeet Soar; Jerry P Nolan; Taku Iwami

doi:10.1016/j.resuscitation.2020.02.044

Out-of-hospital cardiac arrest across the World: First report from the International Liaison Committee on Resuscitation (ILCOR)

Resuscitation. 2020 Jul:152:39-49. doi: 10.1016/j.resuscitation.2020.02.044. Epub 2020 Apr 6.

Authors

Tekeyuki Kiguchi¹, Masashi Okubo², Chika Nishiyama³, Ian Maconochie⁴, Marcus Eng Hock Ong⁵, Karl B Kern⁶, Myra H Wyckoff⁷, Bryan McNally⁸, Erika F Christensen⁹, Ingvild Tjelmeland¹⁰, Johan Herlitz¹¹, Gavin D Perkins¹², Scott Booth¹³, Judith Finn¹⁴, Nur Shahidah¹⁵, Sang Do Shin¹⁶, Bentley J Bobrow¹⁷, Laurie J Morrison¹⁸, Ari Salo¹⁹, Enrico Baldi²⁰, Roman Burkart²¹, Chih-Hao Lin²², Xavier Jouven²³, Jasmeet Soar²⁴, Jerry P Nolan²⁵, Taku Iwami²⁶

Affiliations

¹ Kyoto University Health Service, Kyoto, Japan.
² Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
³ Department of Critical Care Nursing, Kyoto University Graduate School of Human Health Science, Kyoto, Japan.
⁴ Department of Emergency Medicine, Division of Medicine, Imperial College London, London, UK.
⁵ Health Services & Systems Research, Duke-NUS Medical School, Singapore; Department of Emergency Medicine, Singapore General Hospital, Singapore.
⁶ Division of Cardiology, University of Arizona, Sarver Heart Center, Tucson, AZ, USA.
⁷ Division of Neonatal-Perinatal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁸ Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA.
⁹ Center for Prehospital and Emergency Research, Aalborg University and Aalborg University Hospital, Aalborg, Denmark.
¹⁰ Norwegian National Advisory Unit on Prehospital Emergency Medicine (NAKOS), Division of Prehospital Services, Oslo University Hospital, Oslo, Norway.
¹¹ University of Borås, Sahlgrenska University Hospital, Göteborg, Sweden.
¹² Warwick Medical School and University Hospitals Birmingham NHS Foundation Trust, UK.
¹³ Warwick Medical School, University of Warwick, Coventry, UK.
¹⁴ School of Nursing, Midwifery and Paramedicine, Curtin University, WA, Australia; University of Western Australia, WA, Australia; Department of Epidemiology and Preventive Medicine, Monash University, VIC, Australia.
¹⁵ Department of Emergency Medicine, Singapore General Hospital, Singapore.
¹⁶ Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
¹⁷ Department of EMS, McGovern Medical School at UT Health, Houston, TX, USA.
¹⁸ Rescu, Li Ka Shing Knowledge Institute, St. Michael's Hospital and Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
¹⁹ Emergency Medical Services, Department of Emergency Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
²⁰ Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Molecular Medicine, Section of Cardiology, University of Pavia, Pavia, Italy.
²¹ Fondazione Ticino Cuore, Lugano, Switzerland.
²² Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
²³ Department of Cardiology, Georges Pompidou European Hospital, Assistance Publique Hôpitaux de Paris, Paris, France.
²⁴ Intensive Care Medicine, Southmead Hospital, North Bristol NHS Trust, UK.
²⁵ Warwick Medical School, University of Warwick, Coventry and Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK.
²⁶ Kyoto University Health Service, Kyoto, Japan. Electronic address: iwami.taku.8w@kyoto-u.ac.jp.

PMID: 32272235
DOI: 10.1016/j.resuscitation.2020.02.044

Abstract

Background: Since development of the Utstein style recommendations for the uniform reporting of cardiac arrest, increasing numbers of national and regional out-of-hospital cardiac arrest (OHCA) registries have been established worldwide. The International Liaison Committee on Resuscitation (ILCOR) created the Research and Registries Working Group and aimed to systematically report data collected from these registries.

Methods: We conducted two surveys of voluntarily participating national and regional registries. The first survey aimed to identify which core elements of the current Utstein style for OHCA were collected by each registry. The second survey collected descriptive summary data from each registry. We chose the data collected for the second survey based on the availability of core elements identified by the first survey.

Results: Seven national and four regional registries were included in the first survey and nine national and seven regional registries in the second survey. The estimated annual incidence of emergency medical services (EMS)-treated OHCA was 30.0-97.1 individuals per 100,000 population. The combined data showed the median age varied from 64 to 79 years and more than half were male in all 16 registries. The provision of bystander cardiopulmonary resuscitation (CPR) and bystander automated external defibrillator (AED) use was 19.1-79.0% in all registries and 2.0-37.4% among 11 registries, respectively. Survival to hospital discharge or 30-day survival after EMS-treated OHCA was 3.1-20.4% across all registries. Favorable neurological outcome at hospital discharge or 30 days after EMS-treated OHCA was 2.8-18.2%. Survival to hospital discharge or 30-day survival after bystander-witnessed shockable OHCA ranged from 11.7% to 47.4% and favorable neurological outcome from 9.9% to 33.3%.

Conclusion: This report from ILCOR describes data on systems of care and outcomes following OHCA from nine national and seven regional registries across the world. We found variation in reported survival outcomes and other core elements of the current Utstein style recommendations for OHCA across nations and regions.

Keywords: Epidemiology; Out-of-hospital cardiac arrest; Registry; Resuscitation; Utstein template.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cardiopulmonary Resuscitation*
Defibrillators
Emergency Medical Services*
Female
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest* / epidemiology
Out-of-Hospital Cardiac Arrest* / therapy
Registries