tetano
Editor, Senior Moderator
JAMA Netw Open
. 2024 Jan 2;7(1):e2352377.
doi: 10.1001/jamanetworkopen.2023.52377. Out-of-Hospital Cardiac Arrest Following the COVID-19 Pandemic
José Ignacio Ruiz Azpiazu[SUP] 1 [/SUP], Patricia Fernández Del Valle[SUP] 2 [/SUP], Alfredo Echarri Sucunza[SUP] 3 [/SUP], Jose Antonio Iglesias Vázquez[SUP] 4 [/SUP], Carmen Del Pozo[SUP] 5 [/SUP], Emily Caitlin Lily Knox[SUP] 6 [/SUP], Youcef Azeli[SUP] 7 [/SUP], Francisco José Sánchez García[SUP] 8 [/SUP], Cristian Fernández Barreras[SUP] 9 [/SUP], María Carmen Escriche[SUP] 10 [/SUP], Pedro Jesús Martín Hernández[SUP] 11 [/SUP], Marcos Juanes García[SUP] 12 [/SUP], Natividad Ramos García[SUP] 13 [/SUP], Sonia Royo Embid[SUP] 14 [/SUP], José Antonio Cortés Ramas[SUP] 15 [/SUP], Inmaculada Mateo-Rodríguez[SUP] 16 [/SUP], Silvia Sola Muñoz[SUP] 7 [/SUP], Elena Alcalá-Zamora Marcó[SUP] 8 [/SUP], Ana Belén Fornér Canos[SUP] 10 [/SUP], Belén Mainar Gómez[SUP] 14 [/SUP], Pedro Dacal Pérez[SUP] 4 [/SUP], Carmen Camacho Leis[SUP] 13 [/SUP], Jose Javier García Cortés[SUP] 5 [/SUP], José Manuel Hernández Royano[SUP] 11 [/SUP], Xavier Escalada Roig[SUP] 17 [/SUP], Antonio Daponte Codina[SUP] 16 [/SUP], Fernando Rosell Ortiz[SUP] 1 [/SUP]; OHSCAR Investigators Group
Collaborators, Affiliations
Importance: Out-of-hospital cardiac arrest (OHCA) health care provision may be a good indicator of the recovery of the health care system involved in OHCA care following the COVID-19 pandemic. There is a lack of data regarding outcomes capable of verifying this recovery.
Objective: To determine whether return to spontaneous circulation, overall survival, and survival with good neurological outcome increased in patients with OHCA since the COVID-19 pandemic was brought under control in 2022 compared with prepandemic and pandemic levels.
Design, setting, and participants: This observational cohort study was conducted to examine health care response and survival with good neurological outcome at hospital discharge in patients treated following OHCA. A 3-month period, including the first wave of the pandemic (February 1 to April 30, 2020), was compared with 2 periods before (April 1, 2017, to March 31, 2018) and after (January 1 to December 31, 2022) the pandemic. Data analysis was performed in July 2023. Emergency medical services (EMS) serving a population of more than 28 million inhabitants across 10 Spanish regions participated. Patients with OHCA were included if participating EMS initiated resuscitation or continued resuscitation initiated by a first responder.
Exposure: The pandemic was considered to be under control following the official declaration that infection with SARS-CoV-2 was to be considered another acute respiratory infection.
Main outcome and measures: The main outcomes were return of spontaneous circulation, overall survival, and survival at hospital discharge with good neurological outcome, expressed as unimpaired or minimally impaired cerebral performance.
Results: A total of 14 732 patients (mean [SD] age, 64.2 [17.2] years; 10 451 [71.2%] male) were included, with 6372 OHCAs occurring during the prepandemic period, 1409 OHCAs during the pandemic period, and 6951 OHCAs during the postpandemic period. There was a higher incidence of OHCAs with a resuscitation attempt in the postpandemic period compared with the pandemic period (rate ratio, 4.93; 95% CI, 4.66-5.22; P < .001), with lower incidence of futile resuscitation for OHCAs (2.1 per 100 000 person-years vs 1.3 per 100 000 person-years; rate ratio, 0.81; 95% CI, 0.71-0.92; P < .001). Recovery of spontaneous circulation at hospital admission increased from 20.5% in the pandemic period to 30.5% in the postpandemic period (relative risk [RR], 1.08; 95% CI, 1.06-1.10; P < .001). In the same way, overall survival at discharge increased from 7.6% to 11.2% (RR, 1.45; 95% CI, 1.21-1.75; P < .001), with 6.6% of patients being discharged with good neurological status (Cerebral Performance Category Scale categories 1-2) in the pandemic period compared with 9.6% of patients in the postpandemic period (RR, 1.07; 95% CI, 1.04-1.10; P < .001).
Conclusions and relevance: In this cohort study, survival with good neurological outcome at hospital discharge following OHCA increased significantly after the COVID-19 pandemic.
. 2024 Jan 2;7(1):e2352377.
doi: 10.1001/jamanetworkopen.2023.52377. Out-of-Hospital Cardiac Arrest Following the COVID-19 Pandemic
José Ignacio Ruiz Azpiazu[SUP] 1 [/SUP], Patricia Fernández Del Valle[SUP] 2 [/SUP], Alfredo Echarri Sucunza[SUP] 3 [/SUP], Jose Antonio Iglesias Vázquez[SUP] 4 [/SUP], Carmen Del Pozo[SUP] 5 [/SUP], Emily Caitlin Lily Knox[SUP] 6 [/SUP], Youcef Azeli[SUP] 7 [/SUP], Francisco José Sánchez García[SUP] 8 [/SUP], Cristian Fernández Barreras[SUP] 9 [/SUP], María Carmen Escriche[SUP] 10 [/SUP], Pedro Jesús Martín Hernández[SUP] 11 [/SUP], Marcos Juanes García[SUP] 12 [/SUP], Natividad Ramos García[SUP] 13 [/SUP], Sonia Royo Embid[SUP] 14 [/SUP], José Antonio Cortés Ramas[SUP] 15 [/SUP], Inmaculada Mateo-Rodríguez[SUP] 16 [/SUP], Silvia Sola Muñoz[SUP] 7 [/SUP], Elena Alcalá-Zamora Marcó[SUP] 8 [/SUP], Ana Belén Fornér Canos[SUP] 10 [/SUP], Belén Mainar Gómez[SUP] 14 [/SUP], Pedro Dacal Pérez[SUP] 4 [/SUP], Carmen Camacho Leis[SUP] 13 [/SUP], Jose Javier García Cortés[SUP] 5 [/SUP], José Manuel Hernández Royano[SUP] 11 [/SUP], Xavier Escalada Roig[SUP] 17 [/SUP], Antonio Daponte Codina[SUP] 16 [/SUP], Fernando Rosell Ortiz[SUP] 1 [/SUP]; OHSCAR Investigators Group
Collaborators, Affiliations
- PMID: 38261321
- PMCID: PMC10807256
- DOI: 10.1001/jamanetworkopen.2023.52377
Importance: Out-of-hospital cardiac arrest (OHCA) health care provision may be a good indicator of the recovery of the health care system involved in OHCA care following the COVID-19 pandemic. There is a lack of data regarding outcomes capable of verifying this recovery.
Objective: To determine whether return to spontaneous circulation, overall survival, and survival with good neurological outcome increased in patients with OHCA since the COVID-19 pandemic was brought under control in 2022 compared with prepandemic and pandemic levels.
Design, setting, and participants: This observational cohort study was conducted to examine health care response and survival with good neurological outcome at hospital discharge in patients treated following OHCA. A 3-month period, including the first wave of the pandemic (February 1 to April 30, 2020), was compared with 2 periods before (April 1, 2017, to March 31, 2018) and after (January 1 to December 31, 2022) the pandemic. Data analysis was performed in July 2023. Emergency medical services (EMS) serving a population of more than 28 million inhabitants across 10 Spanish regions participated. Patients with OHCA were included if participating EMS initiated resuscitation or continued resuscitation initiated by a first responder.
Exposure: The pandemic was considered to be under control following the official declaration that infection with SARS-CoV-2 was to be considered another acute respiratory infection.
Main outcome and measures: The main outcomes were return of spontaneous circulation, overall survival, and survival at hospital discharge with good neurological outcome, expressed as unimpaired or minimally impaired cerebral performance.
Results: A total of 14 732 patients (mean [SD] age, 64.2 [17.2] years; 10 451 [71.2%] male) were included, with 6372 OHCAs occurring during the prepandemic period, 1409 OHCAs during the pandemic period, and 6951 OHCAs during the postpandemic period. There was a higher incidence of OHCAs with a resuscitation attempt in the postpandemic period compared with the pandemic period (rate ratio, 4.93; 95% CI, 4.66-5.22; P < .001), with lower incidence of futile resuscitation for OHCAs (2.1 per 100 000 person-years vs 1.3 per 100 000 person-years; rate ratio, 0.81; 95% CI, 0.71-0.92; P < .001). Recovery of spontaneous circulation at hospital admission increased from 20.5% in the pandemic period to 30.5% in the postpandemic period (relative risk [RR], 1.08; 95% CI, 1.06-1.10; P < .001). In the same way, overall survival at discharge increased from 7.6% to 11.2% (RR, 1.45; 95% CI, 1.21-1.75; P < .001), with 6.6% of patients being discharged with good neurological status (Cerebral Performance Category Scale categories 1-2) in the pandemic period compared with 9.6% of patients in the postpandemic period (RR, 1.07; 95% CI, 1.04-1.10; P < .001).
Conclusions and relevance: In this cohort study, survival with good neurological outcome at hospital discharge following OHCA increased significantly after the COVID-19 pandemic.