• Emily Andrew, Ziad Nehme, Rory Wolfe, Stephen Bernard, and Karen Smith.
• Department of Research and Evaluation, Ambulance Victoria, Melbourne, Australia.
• Heart. 2017 Jul 1; 103 (14): 1104-1110.

ObjectiveAlthough the factors associated with short-term survival from out-of-hospital cardiac arrest (OHCA) are well established, relatively little is known about the factors that influence long-term survival. In this study, we describe the 15-year survival outcomes of OHCA survivors and examine the influence of peri-arrest factors and 12-month outcomes on long-term survival.MethodsSurvivors of OHCA between 2000 and 2014 identified from the Victorian Ambulance Cardiac Arrest Registry were linked with state-wide death records. Kaplan-Meier survival curves and Cox regression models were used to estimate long-term survival outcomes.ResultsA total of 3449 patients were included with a mean survival duration of 11.9 (95% CI 11.7 to 12.1) years. The 1-year survival rate was 92.2% (95% CI 91.3% to 93.1%), while the 5, 10 and 15-year survival rates were 81.4% (95% CI 79.9% to 82.8%), 70.1% (95% CI 67.9% to 72.1%) and 62.3% (95% CI 58.9% to 65.5%), respectively. The standardised mortality rate of OHCA survivors was 5.6 times that of the standard Australian population in the first-year postarrest, but approached that of the standard population 5 years postarrest. Few peri-arrest factors were independently associated with long-term survival after discharge. Rather, transport to a percutaneous coronary intervention-capable hospital and discharge home from hospital were associated with longevity. Returning to work and favourable physical/functional recovery were associated with improved survival after 12 months.ConclusionsOHCA survivors experience relatively favourable long-term survival after discharge from hospital. While peri-arrest factors had little influence on long-term survival after hospital discharge, favourable recovery postdischarge was associated with improved long-term outcomes.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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