Please use this identifier to cite or link to this item: https://doi.org/10.1161/JAHA.119.015981
Title: Incidence and Outcomes of Out-of-Hospital Cardiac Arrest in Singapore and Victoria: A Collaborative Study
Authors: 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 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
cardiac arrest
emergency medical services
survival
INTERNATIONAL LIAISON COMMITTEE
CARDIOVASCULAR CARE COMMITTEE
ASIAN RESUSCITATION OUTCOMES
AMERICAN-HEART-ASSOCIATION
NEW-ZEALAND COUNCIL
SURVIVAL RATES
EUROPEAN RESUSCITATION
REGIONAL-VARIATION
STROKE FOUNDATION
SOUTHERN AFRICA
Issue Date: 3-Nov-2020
Publisher: WILEY
Citation: 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 (2020-11-03). Incidence and Outcomes of Out-of-Hospital Cardiac Arrest in Singapore and Victoria: A Collaborative Study. JOURNAL OF THE AMERICAN HEART ASSOCIATION 9 (21). ScholarBank@NUS Repository. https://doi.org/10.1161/JAHA.119.015981
Abstract: 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.
Source Title: JOURNAL OF THE AMERICAN HEART ASSOCIATION
URI: https://scholarbank.nus.edu.sg/handle/10635/228744
ISSN: 20479980
DOI: 10.1161/JAHA.119.015981
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