Abstract
Background
The highest achievable survival rate following out-of-hospital cardiac arrest is unknown.
Data from airports serving international destinations (international airports) provide
the opportunity to evaluate the success of pre-hospital resuscitation in a relatively
controlled but real-life environment.
Methods
This retrospective cohort study included all cases of out-of-hospital cardiac arrest
at international airports with resuscitation attempted between January 1st, 2013 and
December 31st, 2015. Crude incidence, patient, event characteristics and survival
to hospital discharge/survival to 30 days (survival) were calculated. Mixed effect
logistic regression analyses were performed to identify predictors of survival. Variability
in survival between airports/countries was quantified using the median odds ratio.
Results
There were 800 cases identified, with an average of 40 per airport. Incidence was
0.024/100,000 passengers per year. Percentage survival for all patients was 32%, and
58% for patients with an initial shockable heart rhythm.
In adjusted analyses, initial shockable heart rhythm was the strongest predictor of
survival (odds ratio, 36.7; 95% confidence interval [CI], 15.5–87.0). In the bystander-witnessed
subgroup, delivery of a defibrillation shock by a bystander was a strong predictor
of survival (odds ratio 4.8; 95% CI, 3.0–7.8). Grouping of cases was significant at
country level and survival varied between countries.
Conclusions
In international airports, 32% of patients survived an out-of-hospital cardiac arrest,
substantially more than in the general population. Our analysis suggested similarity
between airports within countries, but differences between countries. Systematic data
collection and reporting are essential to ensure international airports continually
maximise activities to increase survival.
Keywords
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Article info
Publication history
Published online: March 14, 2018
Accepted:
March 13,
2018
Received in revised form:
March 5,
2018
Received:
January 19,
2018
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at https://doi.org/10.1016/j.resuscitation.2018.03.024.
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
