The epidemiology of out-of-hospital cardiac arrest in Australia and New Zealand: A binational report from the Australasian Resuscitation Outcomes Consortium (Aus-ROC)

Janet Bray; Stuart Howell; Stephen Ball; Tan Doan; Emma Bosley; Karen Smith; Bridget Dicker; Steven Faddy; Melanie Thorrowgood; Andy Swain; Andrew Thomas; Alexander Wilson; Carol Shipp; Tony Walker; Paul Bailey; Judith Finn; Aus-ROC Epistry Management Committee

doi:10.1016/j.resuscitation.2022.01.011

The epidemiology of out-of-hospital cardiac arrest in Australia and New Zealand: A binational report from the Australasian Resuscitation Outcomes Consortium (Aus-ROC)

Resuscitation. 2022 Mar:172:74-83. doi: 10.1016/j.resuscitation.2022.01.011. Epub 2022 Jan 22.

Authors

Janet Bray¹, Stuart Howell², Stephen Ball³, Tan Doan⁴, Emma Bosley⁵, Karen Smith⁶, Bridget Dicker⁷, Steven Faddy⁸, Melanie Thorrowgood⁹, Andy Swain¹⁰, Andrew Thomas¹¹, Alexander Wilson¹², Carol Shipp¹³, Tony Walker¹⁴, Paul Bailey¹⁵, Judith Finn¹⁶; Aus-ROC Epistry Management Committee

Affiliations

¹ Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia. Electronic address: [email protected].
² Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia.
³ Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia; St John Western Australia, Western Australia, Australia.
⁴ Queensland Ambulance Service, Queensland, Australia.
⁵ Queensland Ambulance Service, Queensland, Australia; School of Clinical Sciences, Queensland University of Technology, Queensland, Australia.
⁶ Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Ambulance Victoria, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia.
⁷ St John New Zealand, Auckland, New Zealand; Auckland University of Technology, Auckland, New Zealand.
⁸ NSW Ambulance, New South Wales, Australia.
⁹ SA Ambulance Service, South Australia, Australia.
¹⁰ Wellington Free Ambulance, Wellington, New Zealand.
¹¹ St John Ambulance NT, Northern Territory, Australia.
¹² ACT Ambulance, Australian Capital Territory, Australia.
¹³ Ambulance Tasmania, Tasmania, Australia.
¹⁴ Ambulance Victoria, Victoria, Australia.
¹⁵ St John Western Australia, Western Australia, Australia.
¹⁶ Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia; St John Western Australia, Western Australia, Australia.

PMID: 35077857
DOI: 10.1016/j.resuscitation.2022.01.011

Abstract

Introduction: The Australasian Resuscitation Outcomes Consortium (Aus-ROC) out-of-hospital cardiac arrest (OHCA) Epistry (Epidemiological Registry) now covers 100% of Australia and New Zealand (NZ). This study reports and compares the Utstein demographics, arrest characteristics and outcomes of OHCA patients across our region.

Methods: We included all OHCA cases throughout 2019 as submitted to the Epistry by the eight Australian and two NZ emergency medical services (EMS). We calculated crude and age-standardised incidence rates and performed a national and EMS regional comparison.

Results: We obtained data for 31,778 OHCA cases for 2019: 26,637 in Australia and 5,141 in NZ. Crude incidence was 107.9 per 100,000 person-years in Australia and 103.2/100,000 in NZ. Overall, the majority of OHCAs occurred in adults (96%), males (66%), private residences (76%), were unwitnessed (63%), of presumed medical aetiology (83%), and had an initial monitored rhythm of asystole (64%). In non-EMS-witnessed cases, 38% received bystander CPR and 2% received public defibrillation. Wide variation was seen between EMS regions for all OHCA demographics, arrest characteristics and outcomes. In patients who received an EMS-attempted resuscitation (13,664/31,778): 28% (range across EMS = 13.1% to 36.7%) had return of spontaneous circulation (ROSC) at hospital arrival and 13% (range across EMS = 9.9% to 20.7%) survived to hospital discharge/30-days. Survival in the Utstein comparator group (bystander-witnessed in shockable rhythm) varied across the EMS regions between 27.4% to 42.0%.

Conclusion: OHCA across Australia and NZ has varied incidence, characteristics and survival. Understanding the variation in survival and modifiable predictors is key to informing strategies to improve outcomes.

Keywords: Emergency medical services; Epidemiology; Heart arrest; Out-of-hospital cardiac arrest; Registry; Resuscitation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Australia / epidemiology
Cardiopulmonary Resuscitation*
Emergency Medical Services*
Humans
Male
New Zealand / epidemiology
Out-of-Hospital Cardiac Arrest* / epidemiology
Out-of-Hospital Cardiac Arrest* / therapy
Registries