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Long-term survival following out-of-hospital cardiac arrest
  1. Emily Andrew1,2,
  2. Ziad Nehme1,2,3,
  3. Rory Wolfe2,
  4. Stephen Bernard1,2,4,
  5. Karen Smith1,2,3,5
  1. 1Department of Research and Evaluation, Ambulance Victoria, Melbourne, Australia
  2. 2Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
  3. 3Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Australia
  4. 4Intensive Care Unit, Alfred Hospital, Melbourne, Australia
  5. 5School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Australia
  1. Correspondence to Emily Andrew, Research and Evaluation, Ambulance Victoria, 375 Manningham Road, Doncaster, Victoria 3108 Australia; emily.andrew{at}ambulance.vic.gov.au

Abstract

Objective Although the factors associated with short-term survival from out-of-hospital cardiac arrest (OHCA) are well established, relatively little is known about the factors that influence long-term survival. In this study, we describe the 15-year survival outcomes of OHCA survivors and examine the influence of peri-arrest factors and 12-month outcomes on long-term survival.

Methods Survivors of OHCA between 2000 and 2014 identified from the Victorian Ambulance Cardiac Arrest Registry were linked with state-wide death records. Kaplan-Meier survival curves and Cox regression models were used to estimate long-term survival outcomes.

Results A total of 3449 patients were included with a mean survival duration of 11.9 (95% CI 11.7 to 12.1) years. The 1-year survival rate was 92.2% (95% CI 91.3% to 93.1%), while the 5, 10 and 15-year survival rates were 81.4% (95% CI 79.9% to 82.8%), 70.1% (95% CI 67.9% to 72.1%) and 62.3% (95% CI 58.9% to 65.5%), respectively. The standardised mortality rate of OHCA survivors was 5.6 times that of the standard Australian population in the first-year postarrest, but approached that of the standard population 5 years postarrest. Few peri-arrest factors were independently associated with long-term survival after discharge. Rather, transport to a percutaneous coronary intervention-capable hospital and discharge home from hospital were associated with longevity. Returning to work and favourable physical/functional recovery were associated with improved survival after 12 months.

Conclusions OHCA survivors experience relatively favourable long-term survival after discharge from hospital. While peri-arrest factors had little influence on long-term survival after hospital discharge, favourable recovery postdischarge was associated with improved long-term outcomes.

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Footnotes

  • Contributors EA was responsible for data extraction, analysis and writing the manuscript. RW provided statistical oversight. All authors contributed to and reviewed the final manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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