Prospective, multicenter, Turkish out-of-hospital cardiac arrest study: TROHCA

Author:

Şener Alp12ORCID,Pekdemir Murat3ORCID,İslam Mehmet Muzaffer4ORCID,Aksay Ersin5ORCID,Karahan Sevilay6ORCID,Aksel Gokhan4ORCID,Doğan Nurettin Özgür3ORCID,Öztürk Berkant7ORCID,Hacımustafaoğlu Muhammet7ORCID,Türkücü Çağrı7ORCID,Eroğlu Serkan Emre4ORCID,Yürümez Yusuf8ORCID,Aslan Nuray8ORCID,Güner Necip Gokhan8ORCID,User Neşe Nur9ORCID,Aldemir Hüseyin9ORCID,Girişgin Abdullah Sadik10ORCID,Koçak Sedat10ORCID,Ataman Sami10ORCID,Özhasenekler Ayhan12ORCID,Günaydın Gul Pamukçu12ORCID,Sayhan Mustafa Burak11ORCID,Salt Ömer11ORCID,Bozatlı Satuk Bugra Han11ORCID,Arslan Engin Deniz12ORCID,Yılmaz Fevzi12ORCID,Sivil Ramazan12ORCID,Köksal Özlem13ORCID,Durak Vahide Aslıhan13ORCID,Özdemir Fatma13ORCID,Taş Mahmut14ORCID,Karakoç Yenal14ORCID,Avınca Öner14ORCID,Arık Yunus Emre15ORCID,Melekoğlu Adem15ORCID,Çevrim Özgür15ORCID,Yiğit Özlem16ORCID,Oktay Cem16ORCID,İbze Süleyman16ORCID,Satar Salim17ORCID,Gülen Muge17ORCID,Acehan Selen17ORCID,Altunbaş Erhan18ORCID,Saçak Melis Efeoğlu18ORCID,Ünal Emir18ORCID,Çevik Erdem19ORCID,Satılmış Dilay19ORCID,Asan Hande19ORCID,Karaca Yunus20ORCID,İmamoğlu Melih20ORCID,Özer Vildan20ORCID,Demircan Ahmet21ORCID,Keleş Ayfer21ORCID,Kadı Gültekin21ORCID,Delice Orhan22ORCID,Utlu Sibel Güçlü22ORCID,Arslan Senol22ORCID,Yücel Neslihan23ORCID,Gürbüz Şükrü23ORCID,Ayhan Hüseyin Burak23ORCID,Şen Abdullah24ORCID,Yaman Mahmut24ORCID,Günalp Müge25ORCID,Genç Sinan25ORCID,Baydın Ahmet26ORCID,Çalışkan Fatih26ORCID,Temür Şeyma Arzu26ORCID,Ersel Murat27ORCID,Yalçınlı Sercan27ORCID,Özçete Enver27ORCID,Erbil Bulent28ORCID,Ince Elif Ozturk28ORCID,Karaca Mehmet Ali28ORCID,Çetin Murat29ORCID,Demirbağ Mehmet30ORCID,Sabak Mustafa31ORCID,Bozkurt Mustafa31ORCID

Affiliation:

1. Department of Emergency Medicine, Ankara Bilkent City Hospital, Ankara, Türkiye

2. Department of Emergency Medicine, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Türkiye

3. Department of Emergency Medicine, Kocaeli University, Faculty of Medicine, Kocaeli, Türkiye

4. University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Türkiye

5. Department of Emergency Medicine, İzmir Ekonomi University, Medical Point Hospital, Izmir, Türkiye

6. Department of Biostatistics, Hacettepe University, Faculty of Medicine, Ankara, Türkiye

7. Department of Emergency Medicine, Aksaray University, Aksaray Training and Research Hospital, Aksaray, Türkiye

8. Department of Emergency Medicine, Sakarya University, Faculty of Medicine, Sakarya, Türkiye

9. Department of Emergency Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Türkiye

10. Department of Emergency Medicine, Necmettin Erbakan University, Faculty of Medicine, Konya, Türkiye

11. Department of Emergency Medicine, Trakya University, Faculty of Medicine, Edirne, Türkiye

12. Department of Emergency Medicine, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye

13. Department of Emergency Medicine, Bursa Uludağ University, Faculty of Medicine, Bursa, Türkiye

14. Department of Emergency Medicine, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye

15. Department of Emergency Medicine, University of Health Sciences, İstanbul Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye

16. Department of Emergency Medicine, Akdeniz University, Faculty of Medicine, Antalya, Türkiye

17. Department of Emergency Medicine, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye

18. Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye

19. Department of Emergency Medicine, University of Health Sciences, Sultan 2.Abdülhamid Han Training and Research Hospital, İstanbul, Türkiye

20. Department of Emergency Medicine, Karadeniz Technical University, Faculty of Medicine, Trabzon, Türkiye

21. Department of Emergency Medicine, Gazi University, Faculty of Medicine, Ankara, Türkiye

22. Department of Emergency Medicine, Erzurum City Hospital, Erzurum, Türkiye

23. Department of Emergency Medicine, İnönü University, Turgut Özal Medical Center, Malatya, Türkiye

24. Department of Emergency Medicine, Dicle University, Faculty of Medicine, Diyarbakır, Türkiye

25. Department of Emergency Medicine, Ankara University, Faculty of Medicine, Ankara, Türkiye

26. Department of Emergency Medicine, Ondokuz Mayis University, Faculty of Medicine, Samsun, Türkiye

27. Department of Emergency Medicine, Ege University, Faculty of Medicine, İzmir, Türkiye

28. Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, Ankara, Türkiye

29. Dr.Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Izmir, Türkiye

30. Department of Emergency Medicine, Manisa Merkezefendi State Hospital, Manisa, Türkiye

31. Department of Emergency Medicine, Gaziantep University, Şahinbey Research and Practice Hospital, Gaziantep, Türkiye

Abstract

Abstract OBJECTIVES: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes. MATERIALS AND METHODS: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes. RESULTS: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge. CONCLUSION: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

Publisher

Medknow

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