PREDICTION OF SURVIVAL AFTER OUT-OF-HOSPITAL CARDIAC-ARREST - RESULTSOF A COMMUNITY-BASED STUDY IN VIENNA

The objective of this study was the assessment of out-of-hospital card iac arrest and the definition of possible predictive factors for final hospital discharge. Out of a database of 89 557 consecutive missions of the Vienna emergency medical system (EMS) during 1990, there were 6 23 missions due to a collapse of non-traumatic origin: in 374 cases (6 0.0%) the patients were declared dead without further attempts at resu scitation. The remaining 249 patients were analysed for predictive fac tors at site. Survival to hospital admission: 109 patients survived to hospital admission (43.7%); by-stander support had a small impact (P < 0.05) on survival to hospital arrival whereas age and gender had no predictive power. Most patients with ventricular tachycardia/fibrillat ion (VT/VF) survived primarily (69 of 117, i.e. 59.0%). Survival to ho spital discharge: 27 patients were discharged from hospital care (10.8 %). ECG findings on arrival of the EMS physician at the site proved to be the only powerful predictor for survival: 24 of 117 patients with VT/VF survived compared with only one of 81 with primary asystole, two of 39 with severe bradycardia, and no patient with electromechanical dissociation.