P2750The challenge of long-term survival after an out-of-hospital cardiac arrest: one month is not enough. Our two years experience

Purpose: Many registries has grown up all over the world to measure out-of-hospital cardiac arrests (OHCA) and to improve survival, but many of them stop their follow-up at 1 month after the event. The new challenge, especially for cardiologist, is to comprehend the long-term issues of survivors of cardiac arrest. For these reasons we created, according to the 2014 Utstein style, one of the first registries with a long follow-up (5 years). Methods: All the patients who suffered an OHCA of any aetiology in our Province (about 550000 inhabitants) in whom CPR was attempted were enrolled. The primary endpoint was the survival at 1 month, and the secondary endpoints were the survival at 6 month and then every year until 5 year after OHCA. Results: In the first 2 years (January 2015-December 2016) 931 confirmed OHCA [male 59.7% (n=556); mean age of 74±15.3 years] in which CPR was attempted have been collected. The mean EMS response time was 12:01±5:57 mins. The vast majority of OHCA occurred at home [80.9% (n=753)],than in nursing facilities [8% (n=75)], during work [1% (n=9)], during sport [0.6% (n=6)], in public location [9.1% (n=85)] and in other location [0.3% (n=3)]. About seventy percent of OHCAs were witnessed [Bystanders 523 (56.2%), EMS rescuers 155 (16.6%)]. The rate of bystander CPR were 37.4% (n=290), whilst an AED was used before the EMS arrival in 2.2% (n=17) of cases, with a shock delivered in 52.9% (n=9) of them. Concerning the aetiology 93.5% (n=871) were medical, 4.3% (n=40) traumatic, 0.2% (n=2) by overdose, 0.2% (n=2) by drowning and 1.6% (n=15) asphyxial. The first rhythm was shockable in 17.9% (n=167) (94% VF, 3.6% VT without pulse, 2.4% AED shockable), non-shockable 81.2% (n=756) (62.8% asystole, 30.7% PEA and 6.5% AED non-shockable), whilst was unknown in 0.9% (n=8). According to 2014 Utstein recommendation we calculated the survival of different groups of patients as presented in Table 1.