Survival and quality of life in out-of-hospital cardiac arrest

BACKGROUND: There are few data in Spain on out-of-hospital cardiac arrest and the efficacy of emergency systems. The objectives of the present study were to evaluate an emergency system, comparing survival at hospital discharge according to the origin, cardiac or non-cardiac, of cardiac arrest in out-of-hospital critically ill patients, and to describe the quality of life of the survivors. PATIENTS AND METHODS: Prospective study on 282 patients treated during 1995 and 1996 by ICU ambulances units of the Andalusian Public Health Emergency Company (061) in Granada, Almeria and El Ejido-Poniente (Spain). The Utstein style was followed, gathering the mortality at different times up to 6 months after hospital discharge and the origin (cardiac/non-cardiac) of the arrest. Quality of life 6 months after discharge was collected among survivors. RESULTS: Advanced cardiopulmonary resuscitation (CPR) was applied to 176 (62.4%) patients. The survival rate to discharge was 4.9% for patients with cardiac etiology (7/142 x 100) and 5.9% for those with non-cardiac etiology (2/34 x 100), with non-significant differences between the two groups. An optimal quality of life in all domains, except for pharmacological dependence in seven, was found in the eight survivors 6 months after hospital discharge. CONCLUSIONS: The origin (cardiac/non-cardiac) of out-of-hospital cardiac arrest is not associated with survival at hospital discharge. The survivors exhibit an optimal quality of life 6 months after discharge.