Results of treatment of out-of-hospital cardiopulmonary arrest patients transferred to the UOEH hospital

Abstract

We have accepted patients suffering out-of-hospital cardiopulmonary arrest (CPA) since September 1997. In this study, we retrospectively reviewed the etiology of CPA and the outcome of the patients. We also investigated the effects of the pre-hospital cardiopulmonary resuscitation (CPR) by a bystander or emergency life-saving technicians (ELST) on the restoration of spontaneous circulation. Seventy-seven patients were transferred to our hospital from September 1997 to April 2000, 10 of who underwent bystander (basic) CPR. All the patients underwent advanced CPR by the attending physician immediately after admission to the emergency room. The etiology of CPA was categorized into three groups: (1) unknown endogenous disease (43 patients, 56%), (2) exacerbation of previous disease such as heart, respiratory or cerebrovascular disease (12 patients, 15%), (3) accident or suicide (22 patients, 29%). Spontaneous circulation of 30 patients was restored temporary, but only two patients recovered fully and were discharged from the hospital. The rate of restored spontaneous circulation of the CPA patients with bystander CPR was higher compared to that of the CPA patients without bystander CPR. The two fully recovered patients underwent bystander CPR. The CPR by ELST did not affect the resuscitated rate significantly. These results indicate that the most common etiology of CPA is unknown endogenous disease, and the rate of full recovery is very low (2.6%). This study suggests that bystander CPR may contribute to an improved outcome of the patients suffering out-of-hospital CPA.