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Med J Aust. 2006 Aug 7;185(3):135-9.

Out-of-hospital cardiac arrest in Victoria: rural and urban outcomes.

Author information

1
Rural Ambulance Victoria, Geelong, Victoria. paul.jennings@rav.vic.gov.au

Abstract

OBJECTIVE:

To compare the survival rate from out-of-hospital cardiac arrest in rural and urban areas of Victoria, and to investigate the factors associated with these differences.

DESIGN:

Retrospective case series using data from the Victorian Ambulance Cardiac Arrest Registry.

SETTING:

All out-of-hospital cardiac arrests occurring in Victoria that were attended by Rural Ambulance Victoria or the Metropolitan Ambulance Service.

PARTICIPANTS:

1790 people who suffered a bystander-witnessed cardiac arrest between January 2002 and December 2003.

RESULTS:

Bystander cardiopulmonary resuscitation was more likely in rural (65.7%) than urban areas (48.4%) (P = 0.001). Urban patients with bystander-witnessed cardiac arrest were more likely to arrive at an emergency department with a cardiac output (odds ratio [OR], 2.92; 95% CI, 1.65-5.17; P < 0.001), and to be discharged from hospital alive than rural patients (urban, 125/1685 [7.4%]; rural, 2/105 [1.9%]; OR, 4.13; 95% CI, 1.09-34.91). Major factors associated with survival to hospital admission were distance of cardiac arrest from the closest ambulance branch (OR, 0.87; 95% CI, 0.82-0.92), endotracheal intubation (OR, 3.46; 95% CI, 2.49-4.80), and the presence of asystole (OR, 0.50; 95% CI, 0.38-0.67) or pulseless electrical activity (OR, 0.73; 95% CI, 0.56-0.95) on arrival of the first ambulance crew.

CONCLUSIONS:

Survival rates differ between urban and rural cardiac arrest patients. This is largely due to a difference in ambulance response time. As it is impractical to substantially decrease response times in rural areas, other strategies that may improve outcome after cardiac arrest require investigation.

PMID:
16893352
[Indexed for MEDLINE]
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