Short- and long-term survival after out-of-hospital cardiac arrest in Kaunas (Lithuania) from 2016 to 2018

Linas Darginavicius; Ilona Kajokaite; Nerijus Mikelionis; Jone Vencloviene; Paulius Dobozinskas; Egle Vaitkaitiene; Dinas Vaitkaitis; Asta Krikscionaitiene

doi:10.1186/s12872-022-02964-4

Short- and long-term survival after out-of-hospital cardiac arrest in Kaunas (Lithuania) from 2016 to 2018

BMC Cardiovasc Disord. 2022 Dec 3;22(1):519. doi: 10.1186/s12872-022-02964-4.

Authors

Linas Darginavicius¹, Ilona Kajokaite², Nerijus Mikelionis², Jone Vencloviene³, Paulius Dobozinskas⁴, Egle Vaitkaitiene^{4

5}, Dinas Vaitkaitis⁴, Asta Krikscionaitiene⁴

Affiliations

¹ Department of Disaster Medicine, Lithuanian University of Health Sciences, Eiveniu 4-512, 50161, Kaunas, Lithuania. linas.darginavicius@lsmuni.lt.
² Kaunas Emergency Medical Service Station, Kaunas, Lithuania.
³ Department of Environmental Sciences, Faculty of Natural Sciences, Vytautas Magnus University, Kaunas, Lithuania.
⁴ Department of Disaster Medicine, Lithuanian University of Health Sciences, Eiveniu 4-512, 50161, Kaunas, Lithuania.
⁵ Department of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Abstract

Background: No studies analysing out-of-hospital cardiac arrest (OHCA) epidemiology and outcomes in Lithuania were published in the last decade.

Methods: We conducted a retrospective analysis of prospectively collected data. The incidence of OHCA and the demographics and outcomes of patients who were treated for OHCA between 1 and 2016 and 31 December 2018 at Kaunas Emergency Medical Service (EMS) were collected and are reported in accordance with the Utstein recommendations. Multivariable logistic regression analysis was used to identify predictors of survival to hospital discharge.

Results: In total, 838 OHCA cases of EMS-treated cardiac arrest (CA) were reported (95.8 per 100.000 inhabitants). The median age was 71 (IQR 58-81) years of age, and 66.7% of patients were males. A total of 73.8% of OHCA cases occurred at home, 59.3% were witnessed by a bystander, and 54.5% received bystander cardiopulmonary resuscitation. The median EMS response time was 10 min. Cardiac aetiology was the leading cause of CA (78.8%). The initial rhythm was shockable in 27.6% of all cases. Return of spontaneous circulation at hospital transfer was evident in 24.9% of all cases. The survival to hospital discharge rate was 10.9%, and the 1-year survival rate was 6.9%. The survival to hospital discharge rate in the Utstein comparator group was 36.1%, and the 1-year survival rate was 27.2%. Five factors were associated with improved survival to hospital discharge: shockable rhythm, time from call to arrival at the patient less than 10 min, witnessed OHCA, age < 80 years, and male sex.

Conclusion: This is the first OHCA study from Lithuania examining OHCA epidemiology and outcomes over a three year period. Routine OHCA data collection and analysis will allow us to track the efficacy of service improvements and should become a standard practice in all Lithuanian regions.

Trial registration: This research was registered in the clinicaltrials.gov database: Identifiers: NCT04784117, Unique Protocol ID: LITOHCA. Brief Title: Out-of-hospital Cardiac Arrest Epidemiology and Outcomes in Kaunas 2016-2021.

Keywords: Emergency medical services; Incidence; Out-of-hospital cardiac arrest; Outcomes; Prehospital resuscitation; Survival; Utstein.

MeSH terms

Aged
Aged, 80 and over
Cardiopulmonary Resuscitation*
Emergency Medical Services*
Female
Humans
Lithuania / epidemiology
Male
Out-of-Hospital Cardiac Arrest* / diagnosis
Out-of-Hospital Cardiac Arrest* / epidemiology
Out-of-Hospital Cardiac Arrest* / therapy
Retrospective Studies

Associated data

ClinicalTrials.gov/NCT04784117