Out-of-hospital cardiac arrests in young adults in Melbourne, Australia

Deasy, C., Bray, J.E., Smith, K., Harriss, L.R., Bernard, S.A., and Cameron, P. (2011) Out-of-hospital cardiac arrests in young adults in Melbourne, Australia. Resuscitation, 82 (7). pp. 830-834.

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Abstract

Background: Characteristics and outcomes of out-of-hospital cardiac arrest (OHCA) in young adults are not well described in Australia.

Methods: A 10-year retrospective case review of all OHCA in young adults (aged 16–39) and not witnessed by EMS, was performed using data from the Victorian Ambulance Cardiac Arrest Registry (VACAR).

Results: Between 2000 and 2009 there were 30,006 adult cardiac arrests of which 3912 (13%) were in this age group. The median (IQR) age was 30 (25–35) years for both sexes with a 3:1 male to female ratio. Overdose was the most common precipitant (33.5%) followed by presumed cardiac (20%). Bystander CPR occurred in 21.2%, EMS median response time was 7 min and resuscitation was attempted in 36% of OHCAs. The presenting rhythm was asystole in 84.6%, PEA in 8.8% and VF/VT in 6.6%. Survival to hospital discharge, for all cause OHCA where resuscitation was attempted, was similar for young adult and older adults (8.8% vs 8.4%, p = 0.2). However, for presumed cardiac aetiology OHCA, young adults had a greater proportion of survivors (14.8% vs 9.0%, p < 0.001). Cardiac arrest with shockable rhythm (VF/pulseless VT) had a survival rate of 31.2% for young adults compared to 18.5% for older adults (p < 0.001).

Conclusion: Survival to hospital discharge rates from OHCA due to a 'presumed cardiac' precipitant in young adults is much better than older adults, however, all cause OHCA survival is similar. Multi agency novel upstream preventive strategies aimed at tackling drug overdose may reduce this aetiology of OHCA and save lives.

Item ID: 40476
Item Type: Article (Refereed Research - C1)
Keywords: young adults; out of hospital cardiac arrest; epidemiology; ambulance service; Australia; cardiac arrest registry
ISSN: 1873-1570
Funders: Monash University
Date Deposited: 17 Sep 2015 00:34
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110305 Emergency Medicine @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111706 Epidemiology @ 34%
11 MEDICAL AND HEALTH SCIENCES > 1102 Cardiovascular Medicine and Haematology > 110201 Cardiology (incl Cardiovascular Diseases) @ 32%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 40%
92 HEALTH > 9202 Health and Support Services > 920204 Evaluation of Health Outcomes @ 40%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920409 Injury Control @ 20%
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