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Original research
Long-term outcomes of adult out-of-hospital cardiac arrest in Queensland, Australia (2002–2014): incidence and temporal trends
  1. Katherine Pemberton1,2,
  2. Richard C Franklin1,
  3. Emma Bosley2,
  4. Kerrianne Watt1,2
  1. 1College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
  2. 2Queensland Ambulance Service, Brisbane, Queensland, Australia
  1. Correspondence to Katherine Pemberton, James Cook University, Townsville, QLD 4811, Australia; katherine.pemberton{at}my.jcu.edu.au

Abstract

Objective To describe annual incidence and temporal trends (2002–2014) in incidence of long-term outcomes of adult out-of-hospital cardiac arrest (OHCA) of presumed cardiac aetiology attended by Queensland Ambulance Service (QAS) paramedics, by age, gender, geographical remoteness and socioeconomic status (SES).

Methods This is a retrospective cohort study. Cases were identified using the QAS OHCA Registry and were linked with entries in the Queensland Hospital Admitted Patient Data Collection and the Queensland Registrar General Death Registry. Population data were obtained from the Australian Bureau of Statistics to calculate incidence. Inclusion criteria were adult (18+ years) residents of Queensland who suffered OHCA of presumed cardiac aetiology and survived to hospital admission. Analyses were undertaken by three mutually exclusive outcomes: (1) survival to less than 30 days (Surv<30 days); (2) survival from 30 to 364 days (Surv30–364 days); and (3) survival to 365 days or more (Surv365+ days). Incidence rates were calculated for each year by gender, age, remoteness and SES. Temporal trends were analysed.

Results Over the 13 years there were 4393 cases for analyses. The incidence of total admitted events (9.72–10.13; p<0.01), Surv30–364 days (0.18–0.42; p<0.05) and Surv365+ days (1.94–4.02; p<0.001) increased significantly over time; no trends were observed for Surv<30 days. An increase in Surv365+ days over time was observed in all remoteness categories and most SES categories.

Conclusion Evidence suggests that implemented strategies to improve outcomes from OHCA have been successful and penetrated groups living in more remote locations and the lower socioeconomic groups. These populations still require focus. Ongoing reporting of long-term outcomes from OHCA should be undertaken using population-based incidence.

  • cardiac arrest
  • epidemiology
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Footnotes

  • Twitter @Franklin_R_C

  • Contributors KP and KW were responsible for the conceptual design of the study, with input from the other authors. KP performed the data analysis with assistance from KW. KP was responsible for drafting the manuscript, which was critically reviewed by KW. All authors contributed to critical revision and editing of the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval for this study was obtained from Prince Charles Hospital Human Research Ethics Committee (approval number 15/QPCH/265) and from James Cook University Human Research Ethics Committee (approval number H5752). Access to confidential data was obtained via the Public Health Act through Queensland Health (approval number RD006708).

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

  • Data availability statement Data may be obtained from a third party and are not publicly available.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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