Regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest in Australia and New Zealand: Results from the Aus-ROC Epistry

Ben Beck; Janet Bray; Peter Cameron; Karen Smith; Tony Walker; Hugh Grantham; Cindy Hein; Melanie Thorrowgood; Anthony Smith; Madoka Inoue; Tony Smith; Bridget Dicker; Andy Swain; Emma Bosley; Katherine Pemberton; Michael McKay; Malcolm Johnston-Leek; Gavin D Perkins; Graham Nichol; Judith Finn; Aus-ROC Steering Committee

doi:10.1016/j.resuscitation.2018.02.029

Regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest in Australia and New Zealand: Results from the Aus-ROC Epistry

Resuscitation. 2018 May:126:49-57. doi: 10.1016/j.resuscitation.2018.02.029. Epub 2018 Mar 2.

Authors

Ben Beck¹, Janet Bray², Peter Cameron³, Karen Smith⁴, Tony Walker⁵, Hugh Grantham⁶, Cindy Hein⁷, Melanie Thorrowgood⁸, Anthony Smith⁹, Madoka Inoue¹⁰, Tony Smith¹¹, Bridget Dicker¹², Andy Swain¹³, Emma Bosley¹⁴, Katherine Pemberton¹⁵, Michael McKay¹⁶, Malcolm Johnston-Leek¹⁶, Gavin D Perkins¹⁷, Graham Nichol¹⁸, Judith Finn¹⁹; Aus-ROC Steering Committee

Affiliations

¹ Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia. Electronic address: ben.beck@monash.edu.
² Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia; Emergency and Trauma Centre, The Alfred, Melbourne, Victoria, Australia.
³ Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Emergency and Trauma Centre, The Alfred, Melbourne, Victoria, Australia.
⁴ Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Australia.
⁵ Ambulance Victoria, Victoria, Australia.
⁶ Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia; Flinders University, South Australia, Australia; SA Ambulance Service, South Australia, Australia.
⁷ Flinders University, South Australia, Australia; SA Ambulance Service, South Australia, Australia.
⁸ SA Ambulance Service, South Australia, Australia.
⁹ St John Ambulance Western Australia, Western Australia, Australia.
¹⁰ Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia.
¹¹ St John, Auckland, New Zealand.
¹² St John, Auckland, New Zealand; Auckland University of Technology, Auckland, New Zealand.
¹³ Auckland University of Technology, Auckland, New Zealand; Wellington Free Ambulance, Wellington, New Zealand.
¹⁴ Queensland Ambulance Service, Queensland, Australia; School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
¹⁵ Queensland Ambulance Service, Queensland, Australia.
¹⁶ St John Ambulance NT, Northern Territory, Australia.
¹⁷ Warwick Medical School, University of Warwick, Coventry, United Kingdom.
¹⁸ University of Washington-Harborview Center for Prehospital Emergency Care, University of Washington, Seattle, WA, United States.
¹⁹ Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia; St John Ambulance Western Australia, Western Australia, Australia.

PMID: 29499230
DOI: 10.1016/j.resuscitation.2018.02.029

Abstract

Introduction: The aim of this study was to investigate regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest (OHCA) in Australia and New Zealand.

Methods: This was a population-based cohort study of OHCA using data from the Aus-ROC Australian and New Zealand OHCA Epistry over the period of 01 January 2015-31 December 2015. Seven ambulance services contributed data to the Epistry with a capture population of 19.8 million people. All OHCA attended by ambulance, regardless of aetiology or patient age, were included.

Results: In 2015, there were 19,722 OHCA cases recorded in the Aus-ROC Epistry with an overall crude incidence of 102.5 cases per 100,000 population (range: 51.0-107.7 per 100,000 population). Of all OHCA cases attended by EMS (excluding EMS-witnessed cases), bystander CPR was performed in 41% of cases (range: 36%-50%). Resuscitation was attempted (by EMS) in 48% of cases (range: 40%-68%). The crude incidence for attempted resuscitation cases was 47.6 per 100,000 population (range: 34.7-54.1 per 100,000 population). Of cases with attempted resuscitation, 28% survived the event (range: 21%-36%) and 12% survived to hospital discharge or 30 days (range: 9%-17%; data provided by five ambulance services).

Conclusion: In the first results of the Aus-ROC Australian and New Zealand OHCA Epistry, significant regional variation in the incidence, characteristics and outcomes was observed. Understanding the system-level and public health drivers of this variation will assist in optimisation of the chain of survival provided to OHCA patients with the aim of improving outcomes.

Keywords: Emergency medical service; Epidemiology; Out-of-hospital cardiac arrest; Registry.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Australia / epidemiology
Cardiopulmonary Resuscitation / statistics & numerical data*
Cohort Studies
Emergency Medical Services / statistics & numerical data*
Female
Humans
Incidence
Male
Middle Aged
New Zealand / epidemiology
Out-of-Hospital Cardiac Arrest / epidemiology*
Out-of-Hospital Cardiac Arrest / mortality
Outcome Assessment, Health Care*
Population Surveillance
Registries