Abstract
Aim
Sudden out-of-hospital cardiac arrest (OHCA) is an important public health problem.
While several interventions are known to improve survival, the impact of physician-delivered
advanced cardiac life support for OHCA is unclear. We aimed to assess the association
between prehospital physician involvement and 30-day survival.
Methods
Observational study including persons registered with first-time OHCA of any cause
in the Danish Cardiac Arrest Registry during 2005–2012. We used logistic regression
analysis to assess the association between 30-day survival and involvement of a physician
at any time before arrival at the hospital. Secondary outcomes were 1-year survival
and return of spontaneous circulation (ROSC) before arrival at the hospital. The associations
were explored in three multivariable models: a model with simple adjustment, a model
with multiple imputation of missing variables, and a propensity score model where
exposed subjects were matched 1:1 with unexposed subjects on a propensity score reflecting
the probability of being assigned to the exposure group.
Results
21,165 persons with OHCA during 2005–2012 were included. Overall, 10.8% of OHCA patients
with physician involvement and 8.1% of OHCA patients without physician involvement
before arrival at hospital were alive after 30 days, crude odds ratio (OR) = 1.37 (95% CI = 1.24–1.51), adjusted OR = 1.18 (95% CI = 1.04–1.34). Physician involvement was also positively associated with ROSC, OR = 1.09 (95% CI = 1.00–1.19); and with 1-year survival, OR = 1.13 (95% CI = 0.99–1.29).
Conclusion
In this large population-based observational study, we found prehospital physician
involvement after OHCA associated with better 30-day survival. This association was
also found for ROSC, but with less certainty for 1-year survival.
Keywords
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Article info
Publication history
Published online: August 23, 2016
Accepted:
August 2,
2016
Received in revised form:
July 18,
2016
Received:
June 2,
2016
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2016.08.007.
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
