tetano
Editor, Senior Moderator
J Am Coll Emerg Physicians Open
. 2023 Nov 27;4(6):e13070.
doi: 10.1002/emp2.13070. eCollection 2023 Dec. Updated trends in the outcomes of out-of-hospital cardiac arrest from 2017-2021: Prior to and during the coronavirus disease (COVID-19) pandemic
Cheng-Yi Fan[SUP] 1 [/SUP], Chih-Wei Sung[SUP] 1 2 [/SUP], Ching-Yu Chen[SUP] 3 [/SUP], Chi-Hsin Chen[SUP] 1 [/SUP], Likwang Chen[SUP] 4 [/SUP], Yun-Chang Chen[SUP] 3 [/SUP], Jiun-Wei Chen[SUP] 1 [/SUP], Wen-Chu Chiang[SUP] 2 3 5 [/SUP], Chien-Hua Huang[SUP] 2 5 [/SUP], Edward Pei-Chuan Huang[SUP] 1 2 5 [/SUP]
Affiliations
Objective: This study aims to describe out-of-hospital cardiac arrest (OHCA) characteristics and trends before and during the coronavirus disease-2019 (COVID-19) pandemic in Taiwan.
Methods: We conducted a retrospective cohort study using a 5-year interrupted time series analysis. Eligible adults with non-traumatic OHCAs from January 2017 to December 2021 in 3 hospitals (university medical center, urban second-tier hospital, and rural second-tier hospital) were retrospectively enrolled. Variables were extracted from the emergency medical service reports and medical records. The years 2020 and 2021 were defined as the COVID-19 pandemic period. Outcomes included survival to admission after a sustained return of spontaneous circulation, survival to hospital discharge, and good neurological outcomes (cerebral performance category score 1 or 2).
Results: We analyzed 2819 OHCA, including 1227 from a university medical center, 617 from an urban second-tier hospital, and 975 from a rural second-tier hospital. The mean age was 71 years old, and 60% of patients were males. During the COVID-19 pandemic period, video-assisted endotracheal tube intubation replaced the traditional direct laryngoscopy intubation. The trends of outcomes in the pre-pandemic and pandemic periods varied among different hospitals. Compared with the pre-pandemic period, the outcomes at the university medical center during the COVID-19 pandemic were significantly poorer in several respects. The survival rate on admission dropped from 44.6% to 39.4% (P = 0.037), and the survival rate to hospital discharge fell from 17.5% to 14.9% (P = 0.042). Additionally, there was a notable decrease in patients' good neurological outcomes, declining from 13.2% to 9.7% (P = 0.048). In contrast, the outcomes in urban and rural second-tier hospitals during the COVID-19 pandemic did not significantly differ from those in the pre-pandemic period.
Conclusions: COVID-19 may alter some resuscitation management in OHCAs. There were no overall significant differences in outcomes before and during COVID-19 pandemic, but there were significant differences in outcomes when stratified by hospital types.
Keywords: cardiopulmonary resuscitation; coronavirus disease 2019; outcomes; out‐of‐hospital cardiac arrest; trend.
. 2023 Nov 27;4(6):e13070.
doi: 10.1002/emp2.13070. eCollection 2023 Dec. Updated trends in the outcomes of out-of-hospital cardiac arrest from 2017-2021: Prior to and during the coronavirus disease (COVID-19) pandemic
Cheng-Yi Fan[SUP] 1 [/SUP], Chih-Wei Sung[SUP] 1 2 [/SUP], Ching-Yu Chen[SUP] 3 [/SUP], Chi-Hsin Chen[SUP] 1 [/SUP], Likwang Chen[SUP] 4 [/SUP], Yun-Chang Chen[SUP] 3 [/SUP], Jiun-Wei Chen[SUP] 1 [/SUP], Wen-Chu Chiang[SUP] 2 3 5 [/SUP], Chien-Hua Huang[SUP] 2 5 [/SUP], Edward Pei-Chuan Huang[SUP] 1 2 5 [/SUP]
Affiliations
- PMID: 38029023
- PMCID: PMC10680430
- DOI: 10.1002/emp2.13070
Objective: This study aims to describe out-of-hospital cardiac arrest (OHCA) characteristics and trends before and during the coronavirus disease-2019 (COVID-19) pandemic in Taiwan.
Methods: We conducted a retrospective cohort study using a 5-year interrupted time series analysis. Eligible adults with non-traumatic OHCAs from January 2017 to December 2021 in 3 hospitals (university medical center, urban second-tier hospital, and rural second-tier hospital) were retrospectively enrolled. Variables were extracted from the emergency medical service reports and medical records. The years 2020 and 2021 were defined as the COVID-19 pandemic period. Outcomes included survival to admission after a sustained return of spontaneous circulation, survival to hospital discharge, and good neurological outcomes (cerebral performance category score 1 or 2).
Results: We analyzed 2819 OHCA, including 1227 from a university medical center, 617 from an urban second-tier hospital, and 975 from a rural second-tier hospital. The mean age was 71 years old, and 60% of patients were males. During the COVID-19 pandemic period, video-assisted endotracheal tube intubation replaced the traditional direct laryngoscopy intubation. The trends of outcomes in the pre-pandemic and pandemic periods varied among different hospitals. Compared with the pre-pandemic period, the outcomes at the university medical center during the COVID-19 pandemic were significantly poorer in several respects. The survival rate on admission dropped from 44.6% to 39.4% (P = 0.037), and the survival rate to hospital discharge fell from 17.5% to 14.9% (P = 0.042). Additionally, there was a notable decrease in patients' good neurological outcomes, declining from 13.2% to 9.7% (P = 0.048). In contrast, the outcomes in urban and rural second-tier hospitals during the COVID-19 pandemic did not significantly differ from those in the pre-pandemic period.
Conclusions: COVID-19 may alter some resuscitation management in OHCAs. There were no overall significant differences in outcomes before and during COVID-19 pandemic, but there were significant differences in outcomes when stratified by hospital types.
Keywords: cardiopulmonary resuscitation; coronavirus disease 2019; outcomes; out‐of‐hospital cardiac arrest; trend.