Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin

Erik P. Hess, Ronna L. Campbell, Roger D. White

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

Introduction: The majority of victims who experience out-of-hospital cardiac arrest (OHCA) have ventricular fibrillation (VF) as the presenting rhythm and are thought to have a cardiac etiology for their arrest. Over the past decade, the incidence of VF OHCA has declined. The aims of this study were to describe the epidemiology of OHCA of non-cardiac origin in Olmsted County MN and to determine the trends that have occurred over time. Methods: All residents with a traumatic OHCA from 1995 to 2005 were included for analysis. OHCA data were collected prospectively according to the Utstein method. Cardiac arrests were classified as cardiac or non-cardiac in origin and the etiology determined based on autopsy reports, electronic medical records, and/or emergency medical services reports. Results: During the study period, 414 OHCAs were identified, 90 (21.7%) of which were classified as non-cardiac. Mean age was 61.5 ± 19.7 years. Response time was 7.73 ± 2.9 min, and 40 (44.4%) were bystander-witnessed. Sixty-eight (75.6%) arrests occurred at home, 13 (14.4%) in a public place, and 9 (10%) in other locations. Bystander CPR was performed in 17 (18.9%) cases. The presenting rhythm was VF in 2 (2.2%) cases, PEA in 54 (60%), and asystole in 34 (37.8%). Eight (8.9%) patients survived to hospital discharge. Respiratory failure (35.6%), unknown (15.6%), and pulmonary embolism (13.3%) were the most common etiologies. The mean percentage of arrests due to a non-cardiac cause in three sequential time-periods (1995-1999, 2000-2002, 2003-2005) was 9.4%, 20.1% and 37.7%, respectively. Conclusions: Over the study period, 21.7% of OHCAs were non-cardiac in origin. PEA was the most common presenting rhythm and respiratory failure the most common etiology. 8.9% of patients survived. The decreasing number of VF arrests may be a contributing factor to the increasing proportion of OHCAs of non-cardiac etiology observed in the out-of-hospital setting.

Original languageEnglish (US)
Pages (from-to)200-206
Number of pages7
JournalResuscitation
Volume72
Issue number2
DOIs
StatePublished - Feb 2007

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Out-of-Hospital Cardiac Arrest
Ventricular Fibrillation
Epidemiology
Heart Arrest
Respiratory Insufficiency
Electronic Health Records
Cardiopulmonary Resuscitation
Emergency Medical Services
Pulmonary Embolism
Reaction Time
Autopsy
Incidence

Keywords

  • Cardiopulmonary resuscitation
  • Out-of-hospital CPR
  • Outcome
  • Resuscitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Nursing(all)

Cite this

Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin. / Hess, Erik P.; Campbell, Ronna L.; White, Roger D.

In: Resuscitation, Vol. 72, No. 2, 02.2007, p. 200-206.

Research output: Contribution to journalArticle

Hess, Erik P. ; Campbell, Ronna L. ; White, Roger D. / Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin. In: Resuscitation. 2007 ; Vol. 72, No. 2. pp. 200-206.
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abstract = "Introduction: The majority of victims who experience out-of-hospital cardiac arrest (OHCA) have ventricular fibrillation (VF) as the presenting rhythm and are thought to have a cardiac etiology for their arrest. Over the past decade, the incidence of VF OHCA has declined. The aims of this study were to describe the epidemiology of OHCA of non-cardiac origin in Olmsted County MN and to determine the trends that have occurred over time. Methods: All residents with a traumatic OHCA from 1995 to 2005 were included for analysis. OHCA data were collected prospectively according to the Utstein method. Cardiac arrests were classified as cardiac or non-cardiac in origin and the etiology determined based on autopsy reports, electronic medical records, and/or emergency medical services reports. Results: During the study period, 414 OHCAs were identified, 90 (21.7{\%}) of which were classified as non-cardiac. Mean age was 61.5 ± 19.7 years. Response time was 7.73 ± 2.9 min, and 40 (44.4{\%}) were bystander-witnessed. Sixty-eight (75.6{\%}) arrests occurred at home, 13 (14.4{\%}) in a public place, and 9 (10{\%}) in other locations. Bystander CPR was performed in 17 (18.9{\%}) cases. The presenting rhythm was VF in 2 (2.2{\%}) cases, PEA in 54 (60{\%}), and asystole in 34 (37.8{\%}). Eight (8.9{\%}) patients survived to hospital discharge. Respiratory failure (35.6{\%}), unknown (15.6{\%}), and pulmonary embolism (13.3{\%}) were the most common etiologies. The mean percentage of arrests due to a non-cardiac cause in three sequential time-periods (1995-1999, 2000-2002, 2003-2005) was 9.4{\%}, 20.1{\%} and 37.7{\%}, respectively. Conclusions: Over the study period, 21.7{\%} of OHCAs were non-cardiac in origin. PEA was the most common presenting rhythm and respiratory failure the most common etiology. 8.9{\%} of patients survived. The decreasing number of VF arrests may be a contributing factor to the increasing proportion of OHCAs of non-cardiac etiology observed in the out-of-hospital setting.",
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N2 - Introduction: The majority of victims who experience out-of-hospital cardiac arrest (OHCA) have ventricular fibrillation (VF) as the presenting rhythm and are thought to have a cardiac etiology for their arrest. Over the past decade, the incidence of VF OHCA has declined. The aims of this study were to describe the epidemiology of OHCA of non-cardiac origin in Olmsted County MN and to determine the trends that have occurred over time. Methods: All residents with a traumatic OHCA from 1995 to 2005 were included for analysis. OHCA data were collected prospectively according to the Utstein method. Cardiac arrests were classified as cardiac or non-cardiac in origin and the etiology determined based on autopsy reports, electronic medical records, and/or emergency medical services reports. Results: During the study period, 414 OHCAs were identified, 90 (21.7%) of which were classified as non-cardiac. Mean age was 61.5 ± 19.7 years. Response time was 7.73 ± 2.9 min, and 40 (44.4%) were bystander-witnessed. Sixty-eight (75.6%) arrests occurred at home, 13 (14.4%) in a public place, and 9 (10%) in other locations. Bystander CPR was performed in 17 (18.9%) cases. The presenting rhythm was VF in 2 (2.2%) cases, PEA in 54 (60%), and asystole in 34 (37.8%). Eight (8.9%) patients survived to hospital discharge. Respiratory failure (35.6%), unknown (15.6%), and pulmonary embolism (13.3%) were the most common etiologies. The mean percentage of arrests due to a non-cardiac cause in three sequential time-periods (1995-1999, 2000-2002, 2003-2005) was 9.4%, 20.1% and 37.7%, respectively. Conclusions: Over the study period, 21.7% of OHCAs were non-cardiac in origin. PEA was the most common presenting rhythm and respiratory failure the most common etiology. 8.9% of patients survived. The decreasing number of VF arrests may be a contributing factor to the increasing proportion of OHCAs of non-cardiac etiology observed in the out-of-hospital setting.

AB - Introduction: The majority of victims who experience out-of-hospital cardiac arrest (OHCA) have ventricular fibrillation (VF) as the presenting rhythm and are thought to have a cardiac etiology for their arrest. Over the past decade, the incidence of VF OHCA has declined. The aims of this study were to describe the epidemiology of OHCA of non-cardiac origin in Olmsted County MN and to determine the trends that have occurred over time. Methods: All residents with a traumatic OHCA from 1995 to 2005 were included for analysis. OHCA data were collected prospectively according to the Utstein method. Cardiac arrests were classified as cardiac or non-cardiac in origin and the etiology determined based on autopsy reports, electronic medical records, and/or emergency medical services reports. Results: During the study period, 414 OHCAs were identified, 90 (21.7%) of which were classified as non-cardiac. Mean age was 61.5 ± 19.7 years. Response time was 7.73 ± 2.9 min, and 40 (44.4%) were bystander-witnessed. Sixty-eight (75.6%) arrests occurred at home, 13 (14.4%) in a public place, and 9 (10%) in other locations. Bystander CPR was performed in 17 (18.9%) cases. The presenting rhythm was VF in 2 (2.2%) cases, PEA in 54 (60%), and asystole in 34 (37.8%). Eight (8.9%) patients survived to hospital discharge. Respiratory failure (35.6%), unknown (15.6%), and pulmonary embolism (13.3%) were the most common etiologies. The mean percentage of arrests due to a non-cardiac cause in three sequential time-periods (1995-1999, 2000-2002, 2003-2005) was 9.4%, 20.1% and 37.7%, respectively. Conclusions: Over the study period, 21.7% of OHCAs were non-cardiac in origin. PEA was the most common presenting rhythm and respiratory failure the most common etiology. 8.9% of patients survived. The decreasing number of VF arrests may be a contributing factor to the increasing proportion of OHCAs of non-cardiac etiology observed in the out-of-hospital setting.

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KW - Out-of-hospital CPR

KW - Outcome

KW - Resuscitation

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