TY - JOUR
T1 - Regional variation in out-of-hospital cardiac arrest
T2 - incidence and survival - a nationwide study of regions in Denmark
AU - Møller, Sidsel G
AU - Wissenberg, Mads
AU - Møller-Hansen, Steen
AU - Folke, Fredrik
AU - Malta Hansen, Carolina
AU - Kragholm, Kristian
AU - Bundgaard Ringgren, Kristian
AU - Karlsson, Lena
AU - Lohse, Nicolai
AU - Lippert, Freddy
AU - Køber, Lars
AU - Gislason, Gunnar
AU - Torp-Pedersen, Christian
N1 - Copyright © 2020 Elsevier B.V. All rights reserved.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - AIM: Regional variation in incidence and survival after out-of-hospital cardiac arrest (OHCA) may be caused by many factors including differences in definitions and reporting. We examined regional differences in Denmark.METHODS: From the Danish Cardiac Arrest Registry we identified adult OHCA patients between 2009-2014 of presumed cardiac cause. Patients were grouped according to the five administrative/geographical regions of Denmark and survival was examined based on all arrest-cases (30-day survival percentage) and number of survivors per 100,000 inhabitants.RESULTS: We included 12,902 OHCAs of which 1,550 (12.0%) were alive 30 days after OHCA. No regional differences were observed in age, sex or comorbidities. Incidence of OHCA ranged from 32.9 to 42.4 per 100,000 inhabitants; 30-day survival percentages ranged from 8.5% to 13.8% and number of survivors per 100,000 inhabitants ranged from 3.5 to 5.9, across the regions. In one of the regions car-manned pre-hospital physicians were discontinued from 2011. Here, the incidence of OHCA per 100,000 inhabitants increased markedly from 37.1 in 2011 to 52.2 in 2014 and 30-day survival percentage decreased from 10.9% in 2011 to 7.5% in 2014; while the number of survivors per 100,000 inhabitants stagnated from 4.0 in 2011 to 3.9 in 2014. In comparison, survival increased in the other four regions.CONCLUSION: Differences in incidence and 30-day survival after OHCA were observed between the five regions of Denmark. Comparisons of survival should not only be based on survival percentages, but also on number of survivors of the background population as inclusion bias can influence survival outcomes.
AB - AIM: Regional variation in incidence and survival after out-of-hospital cardiac arrest (OHCA) may be caused by many factors including differences in definitions and reporting. We examined regional differences in Denmark.METHODS: From the Danish Cardiac Arrest Registry we identified adult OHCA patients between 2009-2014 of presumed cardiac cause. Patients were grouped according to the five administrative/geographical regions of Denmark and survival was examined based on all arrest-cases (30-day survival percentage) and number of survivors per 100,000 inhabitants.RESULTS: We included 12,902 OHCAs of which 1,550 (12.0%) were alive 30 days after OHCA. No regional differences were observed in age, sex or comorbidities. Incidence of OHCA ranged from 32.9 to 42.4 per 100,000 inhabitants; 30-day survival percentages ranged from 8.5% to 13.8% and number of survivors per 100,000 inhabitants ranged from 3.5 to 5.9, across the regions. In one of the regions car-manned pre-hospital physicians were discontinued from 2011. Here, the incidence of OHCA per 100,000 inhabitants increased markedly from 37.1 in 2011 to 52.2 in 2014 and 30-day survival percentage decreased from 10.9% in 2011 to 7.5% in 2014; while the number of survivors per 100,000 inhabitants stagnated from 4.0 in 2011 to 3.9 in 2014. In comparison, survival increased in the other four regions.CONCLUSION: Differences in incidence and 30-day survival after OHCA were observed between the five regions of Denmark. Comparisons of survival should not only be based on survival percentages, but also on number of survivors of the background population as inclusion bias can influence survival outcomes.
KW - OHCA
KW - Out-of-hospital cardiac arrest
KW - Regional variation
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85078758439&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2020.01.019
DO - 10.1016/j.resuscitation.2020.01.019
M3 - Journal article
C2 - 32004667
SN - 0300-9572
VL - 148
SP - 191
EP - 199
JO - Resuscitation
JF - Resuscitation
ER -