• Resuscitation · Jun 2022

    Review Meta Analysis

    Global variation in the incidence and outcome of emergency medical services witnessed out-of-hospital cardiac arrest: A systematic review and meta-analysis.

    After Emergency Medical Services witnessed out-of-hospital cardiac arrest, pooled survival is approximately twice as high in Europe (26%) & Australasia (31%), than in North America (14%).

    pearl
    • Paul Gowens, Karen Smith, Gareth Clegg, Brett Williams, and Ziad Nehme.
    • Research Development and Innovation Hub, Scottish Ambulance Service, Edinburgh, Scotland; Resuscitation Research Group, University of Edinburgh, Edinburgh, Scotland.
    • Resuscitation. 2022 Jun 1; 175: 120-132.

    Aim Of The ReviewTo examine global variation in the incidence and outcomes of emergency medical services (EMS) witnessed out-of-hospital cardiac arrest (OHCA).Data SourcesWe systematically reviewed four electronic databases for studies between 1990 and 5th April 2021 reporting EMS-witnessed OHCA populations. Studies were included if they reported sufficient data to calculate the primary outcome of survival to hospital discharge or 30-day survival. Random-effects models were used to pool incidence and survival outcomes, and meta-regression was used to examine sources of heterogeneity. Study quality was appraised using the Joanna Briggs Institute critical appraisal tools.ResultsThe search returned 1178 non-duplicate titles of which 66 articles comprising 133,981 EMS-witnessed patients treated by EMS across 33 countries were included. All but one study was observational and only 12 studies (18%) were deemed to be at low risk of bias. The pooled incidence of EMS-treated cases was 4.1 per 100,000 person-years (95% CI: 3.5, 4.7), varying almost 4-fold across continents. The pooled proportion of survivors to hospital discharge or 30-days was 20% overall (95% CI: 18%, 22%; I2 = 98%), 43% (95% CI: 37%, 49%; I2 = 94%) for initial shockable rhythms and 6% (95% CI: 5%, 8%; I2 = 79%) for initial non-shockable rhythms. In the meta-regression analysis, only region and aetiology were significantly associated with survival. When compared to studies from North America, pooled survival was significantly higher in studies from Europe (14% vs. 26%; p = 0.04) and Australasia (14% vs. 31%, p < 0.001).ConclusionWe identified significant global variation in the incidence and survival outcome of EMS-witnessed OHCA. Further research is needed to understand the factors contributing to these variations.Copyright © 2022 Elsevier B.V. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

    pearl
    1

    After Emergency Medical Services witnessed out-of-hospital cardiac arrest, pooled survival is approximately twice as high in Europe (26%) & Australasia (31%), than in North America (14%).

    Daniel Jolley  Daniel Jolley
     
    Knowledge, pearl, summary or comment to share?

    User can't be blank.

    Content can't be blank.

    Content is too short (minimum is 15 characters).

    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…