Epidemiology of out-of-hospital cardiac arrest in the Bielsko-Biala district: a 12-month analysis

Background: Out-of-hospital cardiac arrest (OHCA) is the sudden, unexpected loss of heart function, which occurs out of specialist healthcare facilities and inevitably leads to death if uninterrupted by effective cardiopulmonary resuscitation (CPR). Aim: To evaluate the circumstances and basic epidemiological indices of OHCA in the population of adult inhabitants of Bielsko-Biala district within 12 months. Methods: On the basis of standard ambulance dispatch cards of the Emergency Medical Services (EMS) teams, a retrospective analysis was made of 272 OHCA cases covering the period from 01.01.2013 to 31.12.2013. We assessed the basic demographic data of the victims, circumstances of the occurrence of OHCA, information on the potential cause and mechanism of the OHCA, and data related to the actions undertaken by witnesses and EMS teams. Results: The overall OHCA incidence was 170/100,000 (243/100,000 in men; 99/100,000 in women). It increased with subjects' age (p < 0.01). The most frequent place of OHCA was the victim's home (82%). OHCA occurred in the presence of witnesses in 60% of cases. CPR was undertaken by a witness in 56% cases. Median CPR duration undertaken by a witness was 10 (IQR 8-14) min. Median time from notification receipt by the EMS to the team arrival was 9 (7-11) min. On the scene, defibrillation rhythm was recognised in 39% of cases. Sixty-seven patients were declared deceased after the arrival of the EMS teams. In the remaining 205 cases, CPR was undertaken, which was ineffective for 141 persons. Median CPR duration undertaken by the EMS team was 30 (20-40) min. The overall prehospital case fatality ratio was 76.5% (75.3% for men; 79.3% for women). Conclusions: OHCA incidence in the Bielsko-Biala population in 2013 was high, increased with age, and was twice as high for men than women. OHCA occurred most often at home, in the presence of a witness; however, CPR was not always undertaken promptly at the scene. CPR was effective for approximately 30% of the victims. The prehospital mortality was high with no differences between genders.