Out-of-hospital cardiac arrest in a teaching hospital in Hong Kong: Descriptive study using the Utstein style

Abstract

Objective: To describe, using the Utstein template, the characteristics of patients presenting with out-of-hospital cardiac arrest to a university teaching hospital in the New Territories of Hong Kong, and to evaluate survival. Design: Prospective study. Setting: The emergency department of a teaching hospital in the New Territories, Hong Kong. Participants: Patients older than 12 years with non-traumatic out-of-hospital cardiac arrest who were transported to the hospital between 1 July 2002 and 31 December 2002. Main outcome measures: Demographic data, characteristics of cardiac arrest and response time intervals of the emergency medical service presented according to the Utstein style, and also survival to hospital discharge rate. Results: A total of 124 patients were included (49.2% male; mean age 71.9 years). The majority of cardiac arrests occurred in patients' home. The overall bystander cardiopulmonary resuscitation (CPR) rate was 15.3% (19/124). The most common electrocardiographic rhythm at scene was asystole, whilst pulseless ventricular tachycardia (VT)/ventricular fibrillation (VF) was found in 18.0%. The overall survival was 0.8% (1/124), and survival to hospital discharge was significantly higher for patients with VF or pulseless VT than those patients with other rhythms of cardiac arrest (11.1% versus 0%). The median witnessed/recognised collapse to defibrillation time was 14 minutes. The median prehospital time interval from collapse/recognition to arrival at hospital was 33 minutes. Conclusion: The prognosis of out-of-hospital cardiac arrest in Hong Kong was poor. Major improvements in every component of the chain of survival are necessary.