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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Out-of-hospital cardiac arrest survival in international airports
Other Titles: Out-of-hospital cardiac arrest survival in international airports
Authors: Masterson, Siobhan
McNally, Bryan
Cullinan, John
Vellano, Kimberly
Escutnaire, Josephine
Fitzpatrick, David
Perkins, Gavin
Koster, Rudolph
Nakajima, Yuko
Pemberton, Katherine
Quinn, Martin
Smith, Karen
Bergbor, Jonsson
Stromsoe, Anneli
Tandan, Meera
Vellinga, Akke
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Keywords: out-of-hospital cardiac arrest resuscitation international
epidemiology survival
Issue Date: 14-Mar-2018
Citation: Masterson S, McNally B, Cullinan J, Vellano K, Escutnaire J, Fitzpatrick D, Perkins G, Koster R, Nakajima Y, Pemberton K, Quinn M, Smith K, Bergbor J, Stromsoe A, Tandan M & Vellinga A (2018) Out-of-hospital cardiac arrest survival in international airports, Resuscitation.
Abstract: Background  The highest achievable survival rate following out-of-hospital cardiac arrest is unknown. Data from airports serving international destinations (international airports) provide the opportunity to evaluate the success of pre-hospital resuscitation in a relatively controlled but real-life environment.  Methods  This retrospective cohort study included all cases of out-of-hospital cardiac arrest at international airports with resuscitation attempted between January 1st, 2013 and December 31st, 2015. Crude incidence, patient, event characteristics and survival to hospital discharge/survival to 30 days (survival) were calculated. Mixed effect logistic regression analyses were performed to identify predictors of survival. Variability in survival between airports/countries was quantified using the median odds ratio.  Results  There were 800 cases identified, with an average of 40 per airport. Incidence was 0.024/100,000 passengers per year. Percentage survival for all patients was 32%, and 58% for patients with an initial shockable heart rhythm.  In adjusted analyses, initial shockable heart rhythm was the strongest predictor of survival (odds ratio, 36.7; 95% confidence interval [CI], 15.5 to 87.0). In the bystander-witnessed subgroup, delivery of a defibrillation shock by a bystander was a strong predictor of survival (odds ratio 4.8; 95% CI, 3.0 to 7.8). Grouping of cases was significant at country level and survival varied between countries.  Conclusions  In international airports, there was 32% of patients survived an out-of-hospital cardiac arrest, substantially more than in the general population. Our analysis suggested similarity between airports within countries, but differences between countries. Systematic data collection and reporting is essential to ensure international airports continually maximise activities to increase survival.
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