Abstract
Objective
To identify predictors of longer-term outcomes from adult out-of-hospital cardiac
arrest of presumed cardiac aetiology.
Methods
In this retrospective cohort study, three large routinely collected databases were
linked: 1)QAS Out-of-Hospital Cardiac (OHCA) Registry; 2)Queensland Hospital Admitted
Patient Data Collection; and 3)Queensland Registrar General Death Registry. Participants
were adult (18years+) residents of Queensland, who suffered an OHCA of presumed cardiac
aetiology and had resuscitation attempted by QAS paramedics between 2002 and 2014.
Four mutually exclusive outcomes were analysed: 1) No pre-hospital return of spontaneous
circulation (ROSC) sustained to the Emergency Department (ED) or ROSC in ED; 2) Survival< 30
days (Pre-hospital ROSC sustained to ED or ROSC in ED but death within 30 days; 3)
survival between 30 and 364 days; and 4) survival to 365 + days. Multinomial logistic
regression was used to calculate odds ratios and 95 % confidence intervals.
Results
Variables significantly predictive of survival to 365 + days after adjusting for all
measured confounders are: an initial shockable rhythm; bystander witnessed events
with bystander CPR; paramedic witnessed events; intubation placement; time of day
(midday-2.59 pm); and attendance by Critical Care Paramedic (CCP).
Conclusion
From a service provision perspective, attendance of a CCP at an OHCA may be an important
factor to achieve preferred long-term outcomes. Enhanced experience, exposure and
expertise, together with extended clinical practice, may explain this finding.
Keywords
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Article info
Publication history
Published online: November 24, 2022
Accepted:
October 30,
2022
Received in revised form:
October 28,
2022
Received:
August 30,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia.
