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Out-of-hospital cardiac arrest survival in international airports

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Masterson, Siobhán, McNally, Bryan, Cullinan, John, Vellano, Kimberly, Escutnaire, Joséphine, Fitzpatrick, David, Perkins, Gavin D., Koster, Rudolph W., Nakajima, Yuko, Pemberton, Katherine, Quinn, Martin, Smith, Karen, Jónsson, Bergþór Steinn, Strömsöe, Anneli, Tandan, Meera and Vellinga, Akke (2018) Out-of-hospital cardiac arrest survival in international airports. Resuscitation, 127 . pp. 58-62. doi:10.1016/j.resuscitation.2018.03.024 ISSN 0300-9572.

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Official URL: http://dx.doi.org/10.1016/j.resuscitation.2018.03....

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Abstract

Background: The highest achievable survival rate following out-of-hospital cardiac arrest is unknown. Data from airports serving international destinations (international airports) provide the opportunity to evaluate the success of pre-hospital resuscitation in a relatively controlled but real-life environment.

Methods: This retrospective cohort study included all cases of out-of-hospital cardiac arrest at international airports with resuscitation attempted between January 1st, 2013 and December 31st, 2015. Crude incidence, patient, event characteristics and survival to hospital discharge/survival to 30 days (survival) were calculated. Mixed effect logistic regression analyses were performed to identify predictors of survival. Variability in survival between airports/countries was quantified using the median odds ratio.

Results: There were 800 cases identified, with an average of 40 per airport. Incidence was 0.024/100,000 passengers per year. Percentage survival for all patients was 32%, and 58% for patients with an initial shockable heart rhythm.

In adjusted analyses, initial shockable heart rhythm was the strongest predictor of survival (odds ratio, 36.7; 95% confidence interval [CI], 15.5-87.0). In the bystander-witnessed subgroup, delivery of a defibrillation shock by a bystander was a strong predictor of survival (odds ratio 4.8; 95% CI, 3.0-7.8). Grouping of cases was significant at country level and survival varied between countries.

Conclusions: In international airports, 32% of patients survived an out-of-hospital cardiac arrest, substantially more than in the general population. Our analysis suggested similarity between airports within countries, but differences between countries. Systematic data collection and reporting are essential to ensure international airports continually maximise activities to increase survival.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Resuscitation
Publisher: Elsevier Ireland Ltd
ISSN: 0300-9572
Official Date: June 2018
Dates:
DateEvent
June 2018Published
14 March 2018Available
13 March 2018Accepted
Volume: 127
Page Range: pp. 58-62
DOI: 10.1016/j.resuscitation.2018.03.024
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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