52 Out of hospital cardiac arrests in young adults (16–35 years); a six-year review of the irish out-of-hospital cardiac arrest register

Introduction Out-of-hospital cardiac arrests (OHCA) in the young population have only been examined in a limited number of regional studies. Hence, we sought to describe OHCA characteristics and predictors of survival to hospital discharge for young Irish adults. Methods An observational analysis of the national Irish out-of-hospital cardiac arrest register for all OHCAs aged 16 to ≤35 years between January 2012 and December 2017 was performed. Multivariable logistic regression was used to determine the independent predictors of survival to hospital discharge. Results A total of 1,005 OHCAs aged 16 to ≤35 years (24.3% female, median age 27 years [IQR 23–32]) had resuscitation attempted over the study period. OHCA location was most commonly in the home (61.3%, n=616) and a minority of OHCAs occurred in areas of sport or recreation (3.5%, n=35). A non-medical aetiology was most prevalent (59%, n=593) with asphyxiation, trauma and drug overdoses accounting for over 90% of these cases. Two-thirds of patients received bystander CPR and a defibrillator was attached to the patient in 14.9% (n=150) of OHCAs before arrival of emergency medical services with a shock being ultimately delivered in 3.9% (n=39) of cases. Overall survival to hospital discharge for the cohort was 6.0% (n=60) and no significant change in survival was noted over the 6-year study period. The rate of survival was dependent on OHCA aetiology, (figure 1). Independent predictors of survival to hospital discharge included bystander witnessed OHCA, a shockable initial rhythm and a bystander defibrillation attempt. Conclusions The high prevalence of non-medical OHCAs and the OHCA location need to be considered when developing OHCA care pathways and preventative strategies to reduce the burden of OHCAs in young adults.