Out-of-hospital cardiac arrest in patients aged 35 years and under: A 4-year study of frequency and survival in London☆

Abstract 

Background

The aim of this study was to describe the frequency and characteristics of cardiac arrest patients of 35 years and under attended by the London Ambulance Service NHS Trust between April 2003 and March 2007. Few large studies have described the occurrence, mechanism, resuscitation viability and outcome of this substantial subset of the cardiac arrest population. By documenting over 3000 cardiac arrests in young people we sought to improve understanding, awareness and ultimately survival of a condition notorious for high mortality rates.

Methods and results

Data were analysed for 3084 young cardiac arrest patients and reported retrospectively. Patients were categorised by age, gender, aetiology and whether or not resuscitation attempts were made.

Over 75% of patients were aged 18–35 years. There were significantly more males in this age group (p<0.001) compared to those aged 17 years or less. The most common cause of cardiac arrest was an underlying cardiac cause (44.9%). Overdoses, hanging and other suicides were found to be major causes of cardiac arrests of non-cardiac origin in young adult males. Sudden Infant Death Syndrome (SIDS) was the most common known cause of death in infants aged less than 1 year. This age group received bystander CPR most often. 5.6% of young cardiac arrest patients who were taken to hospital survived to hospital discharge.

Conclusions

Mortality in young cardiac arrest patients remains high. Focus should be placed on tackling social and psychological causes of cardiac arrest as well as cardiac aetiologies.

Keywords: Emergency medical services, Cardiac arrest, Out-of-hospital CPR, Outcome, Return of spontaneous circulation