Factors Influencing the Survival of the Patients with Prehospital Cardiac Arrest

Background and Objectives:The survival rate of patients with prehospital cardiac arrest in Korea is lower than that seen in other developed countries. The main cause of this low survival rate is that prehospital emerg- ency medical service systems are not yet well established in Korea. This study was undertaken to obtain a fun- damental data for the development of prehospital emergency medical service systems. Materials and Method: We retrospectively analyzed 104 patients with prehospital cardiac arrest on whom cardiopulmonary resuscitat- ion (CPR had been attempted in Sanggye Paik Hospital from January 1998 through December 1999. Results: As for the results of CPR, 43 patients (41.3% showed no return of spontaneous circulation (ROSC, 22 patie- nts (21.2% died within 24 hours, 28 Patients (26.9% survived more than 24 hours but eventually died during admission, and 11 patients (10.6% survived and were discharged. The mean arrest-to-CPR interval was 19.6± 9.0 min. Patients with ROSC and patients who had survived over 24 hours had a shorter arrest-to-CPR interval than those patients without ROSC and patients who died within 24 hours, respectively (p<0.01, p<0.01. The cutting point of the arrest-to-CPR interval for ROSC was 21.3 minutes. Conclusion:The arrest-to-CPR interval is important to improving the survival rate of patients with prehospital cardiac arrest. Additionally, CPR should be attempted aggressively in prehospital cardiac arrests when the arrest-to-CPR interval is within 21.3 minutes, in consideration of the possibility of ROSC. ( ( ((Korean Circulation J 2001;31( ( ( (10 :1059-1065