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Cardiac arrest: Survival rate equally good at any time of day, thanks to an excellent emergency response chain in Vienna

Emergency response service provides consistently high-quality resuscitation measures regardless of the time of day
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(Vienna, 2 Dezember 2019) The time of day or night that someone suffers a cardiac arrest in Vienna has no significant influence upon their chances of survival. This was the finding of a research group led by emergency doctors Christoph Schriefl and Thomas Uray from MedUni Vienna’s Department of Emergency Medicine when they analysed data from 1,811 patients who had suffered a cardiac arrest in Vienna. In this joint study, conducted with the Vienna emergency response service MA 70, the data also showed that the emergency response service provided consistently high-quality resuscitation measures regardless of the time of day. The study has been published in the leading journal "Resuscitation".

As we are all aware, in order to survive a cardiac arrest without any neurological consequences, first aid must be administered as soon as possible. A smooth and efficient emergency response chain is important for ensuring a good outcome. This includes a high quality cardiac massage, performing defibrillation as early as possible, and the subsequent treatment given following successful primary resuscitation. If all of these factors coincide, the chances of a complete recovery are good in Vienna, where 12% of patients survive a cardiac arrest without any subsequent impairment.

A research group led by emergency doctors Christoph Schriefl and Thomas Uray from MedUni Vienna's Department of Emergency Medicine has now shown in a study that, thanks to the excellent healthcare chain in Vienna, the survival rate is good, regardless of the time of day. This study is a joint initiative by MedUni Vienna’s Department of Emergency Medicine and the Vienna emergency response service, MA70.

The aim of the study was to investigate whether the time of day or day of the week or weekend had any impact upon the survival rate and whether there were any differences in the quality of resuscitation measures. This involved analysing data from 1,811 patients, who had suffered an out-of-hospital cardiac arrest between 2013 and 2015. The data are from the Vienna Cardiac Arrest Registry (VICAR), a special register for recording out-of-hospital procedures in the event of cardiac arrest and providing Quality Assurance for the extended resuscitation procedures in Vienna.

Contrary to what one might expect and contrary to the results of several international studies, which show that one-month survival is negatively impacted by suffering a cardiac arrest at night, the results of the study did not show any significant differences between daytime and night-time. Moreover, it was found that, irrespective of the time of day, many people had already been given resuscitation measures by first responders before the emergency services arrived. Of the cases investigated in the study, 58% of the cardiac arrests were observed by other people and, in 57% of cases, resuscitation had already been started prior to arrival of the emergency services. This is not least because the first-aiders who dial the emergency call 144 receive precise instructions from the control center of the emergency response service on how to perform the cardiac pressure massage.

Furthermore, the data showed that the emergency response service provided resuscitation measures of consistently high quality, irrespective of the time of day. These high-quality resuscitation procedures and also the structured treatment received in hospital after successful resuscitation are key factors in ensuring a good outcome.

Says Schriefl: "Amongst other things, the results reflect the decade-long tradition of excellent cooperation and scientific collaboration between the Department of Emergency Medicine and the Vienna emergency response service. Moreover, it underscores the education quality and Quality Management of the Vienna emergency response service. Our data indicated a gratifyingly high rate of assistance from first responders. Nonetheless, our aim must be to increase this even more, to further improve the rate of survival with a good outcome following cardiac arrest."

Service:
"Time of out-of-hospital cardiac arrest is not associated with outcome in a metropolitan area: A multicenter cohort study." C. Schriefl, F.B. Mayr, M. Poppe, A. Zajicek, A. Nürnberger, C. Clodi, H. Herkner, P. Sulzgruber, E. Lobmeyr, A. Schober, M. Holzer, F. Sterz, T. Uray
DOI: doi.org/10.1016/j.resuscitation.2019.07.009.