OHCA survey in Lombardy in the pre covid-19 era

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Mirko Andreoletti
Rodolfo Bonora
Marco Botteri
Cinzia Licia Villa
Giuseppe Maria Sechi
Alberto Zoli
Guido Francesco Villa


OHCA; CPR; Shockable Rhythm; PAD; ROSC; CPC Score; Survival


Background and aim: The incidence of Out of Hospital Cardiac Arrest (OHCA) is estimated at 1/1000 persons/year. In the pre-Covid-19 era world, OHCA survival rate in Europe was 7-6%. The main objective is to analyze OHCA survival in the Lombardy region by highlighting the factors related to both the victims’ characteristics and the chain of survival.


Methods: All OHCAs were grouped into four pre-established periods in 2019 (14-23 January; 15-24 April; 15-24 July; 14-23 October). Following the Utstein method, we selected witnessed OHCAs with presumed cardiac etiology. The outcome of each case was collected in four moments in time: ROSC, ED, 24 hours and 30 days. The neurological outcome 30 days after OHCA was also investigated and stratified with the CPC Score.


Results: We selected 456 cases of OHCA with witnessed cardiac etiology. ROSC was achieved in 121 cases (26.5%), survival in the Emergency Departments in 110 patients (24.1%), after 24 hours in 86 (18.86%) and after 30 days in 72 (15.8%). Male sex was shown to improve OHCA survival. A shockable presentation rhythm, CPR performed by bystanders and the activation of PAD positively influenced OHCA outcome.


Conclusions: Males are more predisposed to incur an OHCA event than females, but they have greater chances of survival. Factors most related to survival are: shockable rhythm, bystanders CPR and the activation of a PAD.


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1. Priori SG, Aliot E, Blomstrom-Lundqvist C, et al. Task force on sudden cardiac death of the European Society of Cardiology. Eur Heart J 2001; 22:1374-450
2. Zipes DP, Libby P, Bonow RO, Braunwal E. Malattie del cuore di Braunwald. In: Trattato di medicina cardiovascolare 7nd ed – Milano: Elvesier Masson Srl 2007 : p. 875-912
3 Aung Myat, Kyoung-Jun Song, Thomas Rea. Out-of-Hospital Cardiac Arrest: current concepts; Lancet 2018; 391:970-9
4. Guido Francesco Villa, Fulvio Kette, Federica Balzarini et al: Out-of-hospital cardiac arrest (OHCA) Survey in Lombardy: data analysis through prospective short time period assessment; Acta Biom Suppl 9-2019
5. ISTAT Database, https://www.tuttitalia.it/lombardia/statistiche/popolazione-andamento-demografico/, Accessed 16 September 2020
6. Ahamed H. Idris, Joost J.L.M. Bierens, et al. 2015 Revised Utstein-Style Recommended Guidelines for Uniform Reporting of Data From Drowning-Related Resuscitation: An ILCOR Advisory Statement; Circulation: Cardiovascular Quality and Outcomes. 2017;10
7. Safar P. Resuscitation after Brain Ischemia. In: Grenvik A and Safar P, editors: Brain Failure and Resuscitation, New York: Churchill Livingstone 1981; 155-84
8. Soar J, Nolan JP, Böttiger BW, et al. European resuscitation council guidelines for resuscitation 2015: Section 3. Adult advanced life support. Resuscitation 2015; 95:100-47
9. Goto, Y., Funada, A., Maeda, T. et al. Sex-specific differences in survival after out-of-hospital cardiac arrest: a nationwide, population-based observational study. Critical Care 2019; 23(263)
10. Jianting Song, Wenxiu Guo. The effect of bystander cardiopulmonary resuscitation on the survival of out-of-hospital cardiac arrests: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med. 2018; 26: 86. Published online 2018 Oct 11. doi: 10.1186/s13049-018-0552-8
11. Jan-Thorsten Gräsnerab, Rolf Lefering, et al. EuReCa ONE: 27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe; Resuscitation 2016; 105: 188-95
12. Matthijs de Visser, Jan Bosch et al. An observational study on survival rates of patients with out-of-hospital cardiac arrest in the Netherlands after improving the ‘chain of survival’. BMJ Open. 2019; 1;9(7):e029254
13. Jolande A Zijlstra 1, Remy Stieglis et al. Local lay rescuers with AEDs, alerted by text messages, contribute to early defibrillation in a Dutch out-of-hospital cardiac arrest dispatch system. Resuscitation 2014; 85:1444-9

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