Factors Influencing the Survival of the Patients with Prehospital Cardiac Arrest

ABSTRACT

BACKGROUND AND OBJECT The survival rate of the patients with prehospital cardiac arrest in Korea is lower than that in other developed countries. The main cause of this low survival rate is that prehospital emergency medical service systems are not yet well established in Korea. This study was undertaken to obtain a fundamental data for the development of prehospital emergency medical service systems. MATERIALS AND METHOD: We retrospectively analized 104 patients with prehospital cardiac arrest on whom cardiopulmonary resuscitation (CPR) had been attempted in Sanggye Paik Hospital from January 1998 through December 1999. RESULTS: As to the CPR results, 43 patients (41.3%) showed no return of spontaneous circulation (ROSC), 22 patients (21.2%) died within 24 hours, 28 Patients (26.9%) survived over 24 hours but eventually died during admission, and 11 patient (10.6%) survived and were discharged. The mean time of the arrest-to-CPR interval was 19.69.0 min. Patients with ROSC and patients who had survived over 24 hours had shorter the arrest-to-CPR interval than patients without ROSC and patients who died within 24 hours, respectively (p<0.01, p<0.01). The cutting point of the arrest-to-CPR interval for ROSC was 21.3 minutes. CONCLUSION: The arrest-to-CPR interval is important to improve the survival rate of the patients with prehospital cardiac arrest. And CPR should be attempted aggresively in prehospital cardiac arrests when the arrest-to-CPR interval is within 21.3 minutes, considering the possibility of ROSC.