A Comparative Study of Survival Rates in Out-of-Hospital Cardiac Arrest Patients Between the time periods before and during the Covid-19 Pandemic in Emergency Room at Vachira Phuket Hospital
Keywords:
Survival rate in emergency room, , ROSC in emergency room, , OHCA survival rate in the Covid-19 Era, , Out-of-hospital cardiac arrestAbstract
Background: Out-of-Hospital Cardiac Arrest (OHCA) is a critical emergency condition with a high mortality rate and has garnered global attention. The COVID-19 pandemic significantly impacted emergency life-saving protocols and the emergency medical services (EMS) system, potentially affecting survival outcomes in OHCA cases. This study aimed to compare survival rates and identify factors associated with the return of spontaneous circulation (ROSC) in OHCA patients before and during the COVID-19 pandemic at Vachira Phuket Hospital.
Objectives: To compare the survival rates of OHCA patients before and during the COVID-19 pandemic, and to investigate factors associated with ROSC.
Methods: A retrospective comparative study was conducted by reviewing medical records of OHCA patients presenting to the Emergency Department of Vachira Phuket Hospital during the pre-pandemic period (February–May 2019) and the pandemic period (February–May 2020). A total of 394 cases were analyzed using descriptive statistics and inferential tests at a significance level of 0.05.
Results: The number of OHCA cases increased by 20.11% during the pandemic. There was a significant rise in EMS transport usage (p = 0.002), a shorter time to initiation of cardiopulmonary resuscitation (p = 0.013), and an increased use of mechanical chest compression devices and personal protective equipment (PPE) (p < 0.001). However, the ROSC rate did not differ significantly between the two periods (p = 0.071), despite a notable increase in pre-hospital termination of resuscitation efforts (p = 0.013).
Conclusions: Although EMS practices during the COVID-19 pandemic were modified to include greater use of PPE and mechanical resuscitation devices, survival outcomes among OHCA patients presenting to the Emergency Department were not significantly different from those in the pre-pandemic period. The observed increase in the rate of pre-hospital termination of resuscitation may have implications for long-term outcomes and warrants further ethical and operational consideration.
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