Please use this identifier to cite or link to this item: https://doi.org/10.1161/JAHA.119.015368
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dc.titleImplementation of a National 5-Year Plan for Prehospital Emergency Care in Singapore and Impact on Out-of-Hospital Cardiac Arrest Outcomes From 2011 to 2016
dc.contributor.authorHo, Andrew Fu Wah
dc.contributor.authorDe Souza, Nurun Nisa Amatullah
dc.contributor.authorBlewer, Audrey L
dc.contributor.authorWah, Win
dc.contributor.authorShahidah, Nur
dc.contributor.authorWhite, Alexander Elgin
dc.contributor.authorNg, Yih Yng
dc.contributor.authorMao, Desmond Renhao
dc.contributor.authorNausheen
dc.contributor.authorGan, Han Nee
dc.contributor.authorChia, Michael Yih Chong
dc.contributor.authorLeong, Benjamin Sieu-Hon
dc.contributor.authorCheah, Si Oon
dc.contributor.authorTham, Lai Peng
dc.contributor.authorOng, Marcus Eng Hock
dc.date.accessioned2022-07-18T01:38:41Z
dc.date.available2022-07-18T01:38:41Z
dc.date.issued2020-11-03
dc.identifier.citationHo, Andrew Fu Wah, De Souza, Nurun Nisa Amatullah, Blewer, Audrey L, Wah, Win, Shahidah, Nur, White, Alexander Elgin, Ng, Yih Yng, Mao, Desmond Renhao, Nausheen, Gan, Han Nee, Chia, Michael Yih Chong, Leong, Benjamin Sieu-Hon, Cheah, Si Oon, Tham, Lai Peng, Ong, Marcus Eng Hock (2020-11-03). Implementation of a National 5-Year Plan for Prehospital Emergency Care in Singapore and Impact on Out-of-Hospital Cardiac Arrest Outcomes From 2011 to 2016. JOURNAL OF THE AMERICAN HEART ASSOCIATION 9 (21). ScholarBank@NUS Repository. https://doi.org/10.1161/JAHA.119.015368
dc.identifier.issn20479980
dc.identifier.urihttps://scholarbank.nus.edu.sg/handle/10635/228732
dc.description.abstractBACKGROUND: Outcomes of patients from out-of-hospital cardiac arrest (OHCA) vary widely globally because of differences in prehospital systems of emergency care. National efforts had gone into improving OHCA outcomes in Singapore in recent years including community and prehospital initiatives. We aimed to document the impact of implementation of a national 5-year Plan for prehospital emergency care in Singapore on OHCA outcomes from 2011 to 2016. METHODS AND RESULTS: Prospective, population-based data of OHCA brought to Emergency Departments were obtained from the Pan-Asian Resuscitation Outcomes Study cohort. The primary outcome was Utstein (bystander witnessed, shockable rhythm) survival-to-discharge or 30-day postarrest. Mid-year population estimates were used to calculate age-standardized incidence. Multivariable logistic regression was performed to identify prehospital characteristics associated with survival-to-discharge across time. A total of 11 465 cases qualified for analysis. Age-standardized incidence increased from 26.1 per 100 000 in 2011 to 39.2 per 100 000 in 2016. From 2011 to 2016, Utstein survival rates nearly doubled from 11.6% to 23.1% (P=0.006). Overall survival rates improved from 3.6% to 6.5% (P<0.001). Bystander cardiopulmonary resuscitation rates more than doubled from 21.9% to 56.3% and bystander automated external defibrillation rates also increased from 1.8% to 4.6%. Age ≤65 years, nonresidential location, witnessed arrest, shockable rhythm, bystander automated external defibrillation, and year 2016 were independently associated with improved survival. CONCLUSIONS: Implementation of a national prehospital strategy doubled OHCA survival in Singapore from 2011 to 2016, along with corresponding increases in bystander cardiopulmonary resuscitation and bystander automated external defibrillation. This can be an implementation model for other systems trying to improve OHCA outcomes.
dc.language.isoen
dc.publisherWILEY
dc.sourceElements
dc.subjectScience & Technology
dc.subjectLife Sciences & Biomedicine
dc.subjectCardiac & Cardiovascular Systems
dc.subjectCardiovascular System & Cardiology
dc.subjectbystander CPR
dc.subjectemergency medical services
dc.subjectinterventions
dc.subjectoutcomes
dc.subjectout&#8208
dc.subjectof&#8208
dc.subjecthospital&#8208
dc.subjectcardiac arrest
dc.subjectprehospital
dc.subjectresuscitation
dc.subjectASIAN RESUSCITATION OUTCOMES
dc.subjectMEDICAL-SERVICES SYSTEMS
dc.subjectHEALTH-PROFESSIONALS
dc.subjectSURVIVAL
dc.subjectASSOCIATION
dc.subjectIMPROVEMENTS
dc.subjectCOUNTRIES
dc.subjectINTERVENTION
dc.subjectSTATEMENT
dc.subjectCHAIN
dc.typeArticle
dc.date.updated2022-07-15T01:58:30Z
dc.contributor.departmentDEAN'S OFFICE (DUKE-NUS MEDICAL SCHOOL)
dc.contributor.departmentDEPT OF SURGERY
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.contributor.departmentSAW SWEE HOCK SCHOOL OF PUBLIC HEALTH
dc.description.doi10.1161/JAHA.119.015368
dc.description.sourcetitleJOURNAL OF THE AMERICAN HEART ASSOCIATION
dc.description.volume9
dc.description.issue21
dc.published.statePublished
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