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

Keywords

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

Abstract

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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