OHCA survey in Lombardy: comparison between years 2014 and 2019 (pre COVID-19)

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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: Return of spontaneous circulation (ROSC), Emergency Department (ED), 24 hours and 30 days. The neurological outcome 30 days after OHCA was also investigated and stratified with the Cerebral Performance Category Score (CPC). 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, Cardiopulmonary Resuscitation (CPR) performed by bystanders and the activation of Public Access Defibrillation (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. (www.actabiomedica.it)


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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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