Outcome of Out-of-Hospital Cardiac Arrest in New York City

摘要: Objective. —To determine survival from out-of-hospital cardiac arrest in New York City and to compare this with other urban, suburban, rural areas. Design. —Observational cohort study. Setting. —New City. Participants. —Consecutive arrests occurring between October 1, 1990, April 1991. Intervention. —Trained paramedics performed immediate postarrest interviews care providers, using a standardized questionnaire. Main Outcome Measures. —Entry criteria, elapsed time intervals, nodal events conformed Utstein recommendations. The single target end point was death or discharge home. Results. —Of 3243 consecutive on which resuscitation attempted, 2329 (72%) met entry criteria as primary events. Overall 1.4% (99% confidence interval [CI], 0.9% 2.3%). No patients were lost follow-up. Survival witnessed ventricular fibrillation 5.3% CI, 2.9% 8.8%). Using for intersystem comparison, our rate similar that of Chicago, III (4.0%; 99% 1.9% 7.5%; P =.41), the only large city data available. However, it significantly lower than reported midsized urban/suburban areas (33.0%; 30.4% 35.6%; =.41) but markedly King County, Washington (36%; 28.6% 43.8%; Conclusions. —Survival poor. This partly attributable lengthy intervals at every step chain survival. examination among after emergency medical services arrival suggests features may predispose residents cities higher mortality individuals living more suburban settings. Since half US population resides metropolitan areas, represents public health problem considerable magnitude. ( JAMA . 1994;271:678-683)