Predictors of Mortality in Out-of-hospital Cardiac Arrest (OHCA) Patients: A Retrospective Cross-sectional Study from the Sultanate of Oman

Background: Out-of-hospital cardiac arrest (OHCA) is a significant global health challenge with high incidence and low survival rates; this study aimed to predict mortality in these patients. Methods: This 5-year retrospective chart review, conducted at the emergency departments (EDs) of two tertiary hospitals, systematically categorized, coded, and analyzed variables to assess mortality risk in OHCA patients. Results: Of the 822 (36.5%) patients who met the inclusion criteria, the mean age was 60.2 years (SD +/- 17.6), with 65.7% being male. Cardiopulmonary resuscitation (CPR) was attempted on 586 patients, with 178 (30.4%) achieving return of spontaneous circulation (ROSC) in the ED. Significant riskfactors for mortality included hypertension (p = 0.01), diabetes mellitus (p = 0.05), respiratory illnesses (p = 0.04), and having three or more comorbidities (p = 0.01). Manifestations in previous ED visits (<180 days), such as cardiac complaints (p = 0.05) and dyspnea due to fluid overload (p = 0.02), were significant. Among the cohort, 76.4% visited the ED (<180 days) and had a mortality rate of 95.7%, compared to 78.4% for those who did not visit. Asystole and pulseless electrical activity (PEA) were significant factors for the nonachievement of ROSC (p < 0.001 vs p = 0.032) and mortality (p < 0.001 vs p = 0.03). Overall, 49 patients (8.4%) survived to hospital discharge. Conclusion: Elderly males with hypertension, diabetes, respiratory ailments, and multiple comorbidities constituted a significant risk group. Factors such as prior episodes of chest pain and fluid overload were associated with higher mortality. Patients with asystole and PEA had low survival rates.