Incidence and outcomes of out-of-hospital cardiac arrest in singapore and Victoria : a collaborative study
Background: Incidence and outcomes of out-of-hospital cardiac arrest (OHCA) vary between communities. We aimed to examine differences in patient characteristics, prehospital care, and outcomes in Singapore and Victoria. Methods and Results: Using the prospective Singapore Pan-Asian Resuscitation Out...
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sg-ntu-dr.10356-1460772023-03-05T16:47:16Z Incidence and outcomes of out-of-hospital cardiac arrest in singapore and Victoria : a collaborative study Lim, Shir Lynn Smith, Karen Dyson, Kylie Chan, Siew Pang Earnest, Arul Nair, Resmi Bernard, Stephen Leong, Benjamin Sieu-Hon Arulanandam, Shalini Ng, Yih Yng Ong, Marcus Eng Hock Lee Kong Chian School of Medicine (LKCMedicine) Science::Medicine Cardiac Arrest Emergency Medical Services Background: Incidence and outcomes of out-of-hospital cardiac arrest (OHCA) vary between communities. We aimed to examine differences in patient characteristics, prehospital care, and outcomes in Singapore and Victoria. Methods and Results: Using the prospective Singapore Pan-Asian Resuscitation Outcomes Study and Victorian Ambulance Cardiac Arrest Registry, we identified 11 061 and 32 003 emergency medical services-attended adult OHCAs between 2011 and 2016 respectively. Incidence and survival rates were directly age adjusted using the World Health Organization population. Survival was analyzed with logistic regression, with model selection via backward elimination. Of the 11 061 and 14 834 emergency medical services-treated OHCAs (overall mean age±SD 65.5±17.2; 67.4% males) in Singapore and Victoria respectively, 11 054 (99.9%) and 5595 (37.7%) were transported, and 440 (4.0%) and 2009 (13.6%) survived. Compared with Victoria, people with OHCA in Singapore were older (66.7±16.5 versus 64.6±17.7), had less shockable rhythms (17.7% versus 30.3%), and received less bystander cardiopulmonary resuscitation (45.7% versus 58.5%) and defibrillation (1.3% versus 2.5%) (all P<0.001). Age-adjusted OHCA incidence and survival rates increased in Singapore between 2011 and 2016 (P<0.01 for trend), but remained stable, though higher, in Victoria. Likelihood of survival increased significantly (P<0.001) with arrest in public locations (adjusted odds ratio [aOR] 1.81), witnessed arrest (aOR 2.14), bystander cardiopulmonary resuscitation (aOR 1.72), initial shockable rhythm (aOR 9.82), and bystander defibrillation (aOR 2.04) but decreased with increasing age (aOR 0.98) and emergency medical services response time (aOR 0.91). Conclusions: Singapore reported increasing OHCA incidence and survival rates between 2011 and 2016, compared with stable, albeit higher, rates in Victoria. Survival differences might be related to different emergency medical services practices including patient selection for resuscitation and transport. Ministry of Health (MOH) National Medical Research Council (NMRC) Published version PAROS is supported by grants from the National Medical Research Council (Singapore), Ministry of Health, Singapore. VACAR receives funding from Victorian Government Department of Health. 2021-01-25T09:21:30Z 2021-01-25T09:21:30Z 2020 Journal Article Lim, S. L., Smith, K., Dyson, K., Chan, S. P., Earnest, A., Nair, R., … Ong, M. E. (2020). Incidence and outcomes of out-of-hospital cardiac arrest in Singapore and Victoria : a collaborative study. Journal of the American Heart Association, 9(21), e015981-. doi:10.1161/jaha.119.015981 2047-9980 https://hdl.handle.net/10356/146077 10.1161/JAHA.119.015981 33094661 2-s2.0-85095667822 21 9 en Journal of the American Heart Association © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. application/pdf |
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Science::Medicine Cardiac Arrest Emergency Medical Services Lim, Shir Lynn Smith, Karen Dyson, Kylie Chan, Siew Pang Earnest, Arul Nair, Resmi Bernard, Stephen Leong, Benjamin Sieu-Hon Arulanandam, Shalini Ng, Yih Yng Ong, Marcus Eng Hock Incidence and outcomes of out-of-hospital cardiac arrest in singapore and Victoria : a collaborative study |
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Background: Incidence and outcomes of out-of-hospital cardiac arrest (OHCA) vary between communities. We aimed to examine differences in patient characteristics, prehospital care, and outcomes in Singapore and Victoria. Methods and Results: Using the prospective Singapore Pan-Asian Resuscitation Outcomes Study and Victorian Ambulance Cardiac Arrest Registry, we identified 11 061 and 32 003 emergency medical services-attended adult OHCAs between 2011 and 2016 respectively. Incidence and survival rates were directly age adjusted using the World Health Organization population. Survival was analyzed with logistic regression, with model selection via backward elimination. Of the 11 061 and 14 834 emergency medical services-treated OHCAs (overall mean age±SD 65.5±17.2; 67.4% males) in Singapore and Victoria respectively, 11 054 (99.9%) and 5595 (37.7%) were transported, and 440 (4.0%) and 2009 (13.6%) survived. Compared with Victoria, people with OHCA in Singapore were older (66.7±16.5 versus 64.6±17.7), had less shockable rhythms (17.7% versus 30.3%), and received less bystander cardiopulmonary resuscitation (45.7% versus 58.5%) and defibrillation (1.3% versus 2.5%) (all P<0.001). Age-adjusted OHCA incidence and survival rates increased in Singapore between 2011 and 2016 (P<0.01 for trend), but remained stable, though higher, in Victoria. Likelihood of survival increased significantly (P<0.001) with arrest in public locations (adjusted odds ratio [aOR] 1.81), witnessed arrest (aOR 2.14), bystander cardiopulmonary resuscitation (aOR 1.72), initial shockable rhythm (aOR 9.82), and bystander defibrillation (aOR 2.04) but decreased with increasing age (aOR 0.98) and emergency medical services response time (aOR 0.91). Conclusions: Singapore reported increasing OHCA incidence and survival rates between 2011 and 2016, compared with stable, albeit higher, rates in Victoria. Survival differences might be related to different emergency medical services practices including patient selection for resuscitation and transport. |
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Lee Kong Chian School of Medicine (LKCMedicine) |
author_facet |
Lee Kong Chian School of Medicine (LKCMedicine) Lim, Shir Lynn Smith, Karen Dyson, Kylie Chan, Siew Pang Earnest, Arul Nair, Resmi Bernard, Stephen Leong, Benjamin Sieu-Hon Arulanandam, Shalini Ng, Yih Yng Ong, Marcus Eng Hock |
format |
Article |
author |
Lim, Shir Lynn Smith, Karen Dyson, Kylie Chan, Siew Pang Earnest, Arul Nair, Resmi Bernard, Stephen Leong, Benjamin Sieu-Hon Arulanandam, Shalini Ng, Yih Yng Ong, Marcus Eng Hock |
author_sort |
Lim, Shir Lynn |
title |
Incidence and outcomes of out-of-hospital cardiac arrest in singapore and Victoria : a collaborative study |
title_short |
Incidence and outcomes of out-of-hospital cardiac arrest in singapore and Victoria : a collaborative study |
title_full |
Incidence and outcomes of out-of-hospital cardiac arrest in singapore and Victoria : a collaborative study |
title_fullStr |
Incidence and outcomes of out-of-hospital cardiac arrest in singapore and Victoria : a collaborative study |
title_full_unstemmed |
Incidence and outcomes of out-of-hospital cardiac arrest in singapore and Victoria : a collaborative study |
title_sort |
incidence and outcomes of out-of-hospital cardiac arrest in singapore and victoria : a collaborative study |
publishDate |
2021 |
url |
https://hdl.handle.net/10356/146077 |
_version_ |
1759856454803652608 |