• Resuscitation · Mar 2022

    Outcomes of out-of-hospital cardiac arrests after a decade of system-wide initiatives optimising community chain of survival in Taipei city.

    • Hao-Yang Lin, Yu-Chun Chien, Bin-Chou Lee, Yung-Lung Wu, Yueh-Ping Liu, Tzong-Luen Wang, Patrick Chow-In Ko, Kah-Meng Chong, Hui-Chih Wang, Edward Pei-Chuan Huang, Jen-Tang Sun, Ming-Ju Hsieh, Sheng-Wen Hou, Wen-Shuo Yang, Yao-Cheng Wang, Chien-Hua Huang, Wen-Chu Chiang, Matthew Huei-Ming Ma, and Taipei City Fire Department Quality Assurance Team.
    • Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
    • Resuscitation. 2022 Mar 1; 172: 149-158.

    ObjectiveA strengthened chain of survival benefits patient outcomes after out-of-hospital cardiac arrest (OHCA).2 Over the past decade, the Taipei Fire Department (TFD) has continuously implemented system-wide initiatives on this issue.We hypothesised that for adult, non-trauma OHCA patients, the bundle of these system-wide initiatives are associated with better outcomes.MethodsWe conducted a registry-based, retrospective study to examine the association between consecutive system-level initiatives and OHCA survival on a two-yearly basis using trend analysis and multivariable logistic regression. The primary outcome was survival to hospital discharge (STHD) and favourable neurological status.ResultsWe analysed 18,076 cases from 2008 to 2017. The numbers of two-yearly cases of OHCA with resuscitation attempts from 2008 to 2017 were 3,576, 3,456, 3,822, 3,811, and 3,411. There was a significant trend of improved STHD (Two-fold) and favourable neurological outcome (Six-fold) over the past decade. Similar trends were observed in the shockable and non-shockable groups. Considering the first 2 years as baseline, the odds of STHD and favourable neurological status in the end of the initiatives increased significantly after adjusting for universally recognised predictors for OHCA survival.ConclusionFor non-trauma adult OHCA in Taipei, continuous, multifaceted system-wide initiatives on the community chain of survival were associated with improved odds of STHD and favourable neurologic outcomes.Copyright © 2021. Published by Elsevier B.V.

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