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The relationship between time to arrival of emergency medical services (EMS) and survival from out-of-hospital ventricular fibrillation cardiac arrest.

Abstract：

AIM:We examined the relationship between time from collapse to arrival of emergency medical services (EMS) and survival to hospital discharge for out-of-hospital ventricular fibrillation cardiac arrests in order to determine meaningful interpretations of this association. METHODS:We calculated survival rates in 1-min intervals from collapse to EMS arrival. Additionally, we used logistic regression to determine the absolute probability of survival per minute of delayed EMS arrival. We created a logistic regression model with spline terms for the time variable to examine the decline in survival in intervals that are hypothesized to be physiologically relevant. RESULTS:The observed data showed survival declined, on average, by 3% for each minute that EMS was delayed following collapse. Survival rates did not decline appreciably if the time between collapse and arrival of EMS was 4 min or less but they declined by 5.2% per minute between 5 and 10 min. EMS arrival 11-15 min after collapse showed a less steep decline in survival of 1.9% per minute. The spline model that incorporated changes in slope in the time interval variable modeled this relationship more accurately than a model with a continuous term for time (p=0.01). CONCLUSIONS:The results of our analyses show that survival from out-of-hospital cardiac arrest does not decline at a constant rate following collapse. Models that incorporate changes that reflect the physiological alterations that occur following cardiac arrests are a more accurate way to describe changes in survival rates over time than models that include only a continuous term for time.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Gold LS,Fahrenbruch CE,Rea TD,Eisenberg MS

doi

10.1016/j.resuscitation.2010.02.004

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

622-5

issue

5

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(10)00084-5

journal_volume

81

pub_type

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