Epidemiology, management, and survival rate of out-of-hospital cardiac arrest in Upper Silesia, Poland: an Utstein-style report

Introduction: Despite the growing number of studies on the epidemiology of out-of-hospital cardiac arrest (OHCA) in Poland, this issue has not been sufficiently studied. Notably, there has been a lack of uniform Utstein-style data reporting. Aim: To evaluate the epidemiology of OHCA, patient characteristics, the laypeople and emergency medical service (EMS) response to cardiac arrest, and outcomes of OHCA patients, based on a prospective registry encompassing a population of 2.7 million Poles. Material and methods: Consecutive, adult, EMS-treated OHCA cases in 2018 were analyzed. Prehospital data were collected using case report forms by EMS. Information on in-hospital procedures and outcomes was based on data from the public payer of health care services. Multivariable logistic regression analysis was performed to find independent predictors of survival to discharge. Results: A total of 1392 patients were included. Most OHCA occurred at home (74.7%). In 66.8% of OHCA cases, the cardiac arrest was witnessed by bystanders and in another 20.4% by EMS. Laypeople performed cardiopulmonary resuscitation (CPR) in 54.4% of non-EMS-witnessed events, and an automated external defibrillator (AED) was used in 4.6% of patients who received bystander CPR. Finally, 30.7% of all patients were transported to the hospital, and 9.2% survived to hospital discharge. Epinephrine administration, unwitnessed OHCA, longer response time, older age, and initial non-shockable rhythm were independently associated with lower survival to discharge. Conclusions: The prognosis of OHCA patients in Poland is poor. There is still room for improvement in increasing the prevalence of bystander CPR and AED use before EMS arrival.

Automated summary

This study evaluated the epidemiology of out-of-hospital cardiac arrest (OHCA) cases in Poland in 2018, finding that the majority occurred at home, were witnessed by bystanders, and had a low survival rate. Factors associated with lower survival included epinephrine administration, unwitnessed events, longer response times, older age, and initial non-shockable rhythms. Improvements in bystander CPR and AED use before EMS arrival are needed to enhance outcomes.