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dc.contributor.authorMajewski, David
dc.contributor.authorBall, Stephen
dc.contributor.authorBailey, Paul
dc.contributor.authorMckenzie, Nicole
dc.contributor.authorBray, Janet
dc.contributor.authorMorgan, Alani
dc.contributor.authorFinn, Judith
dc.identifier.citationMajewski, D. and Ball, S. and Bailey, P. and Mckenzie, N. and Bray, J. and Morgan, A. and Finn, J. 2021. Survival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies. Resuscitation.

AIM: The 2015 Utstein guidelines stated that 30-day survival could be used as an alternative to survival to hospital discharge (STHD) as the primary survival outcome in out-of-hospital cardiac arrest (OHCA) studies. We sought to ascertain the equivalence (concordance) of these two survival outcome measures.

METHODS: We conducted a population-based retrospective cohort study of OHCA patients who were attended by St John Western Australia (SJ-WA) paramedics in Perth, WA between 1999 and 2018. OHCA patients were included if they received either an attempted resuscitation by SJ-WA or bystander defibrillation; were a resident of WA; and were transported to a hospital emergency department (ED). STHD was determined through hospital record review and 30-day survival via the WA Death Registry and cemetery registration data.

RESULTS: The study cohort comprised a total of 7,953 OHCA patients, predominantly male (70%), with a median (IQR) age of 63 (46-77 years), a presumed cardiac arrest aetiology (78.9%), and the majority occurred in a private residence (66.8%). Survival rates were identical for STHD and 30-day survival, with both being (13.78%, 95% CI: 13.02-14.54%) (p > 0.99). The overall concordance between the two survival rates was 99.6%. There were only 30 (0.4%) discordant cases in total: 15 cases with STHD-yes but 30-day survival-no; and 15 cases with STHD-no but 30-day survival-yes.

CONCLUSION: We found that STHD and 30-day survival were equivalent survival metrics in our OHCA Registry. However, given potential differences in health systems, we suggest that 30-day survival is likely to enable more reliable comparisons across jurisdictions.

dc.titleSurvival to hospital discharge is equivalent to 30-day survival as a primary survival outcome for out-of-hospital cardiac arrest studies.
dc.typeJournal Article
curtin.departmentCurtin School of Nursing
curtin.accessStatusOpen access
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidFinn, Judith [0000-0002-7307-7944]
curtin.contributor.researcheridFinn, Judith [B-2678-2010]
curtin.contributor.scopusauthoridFinn, Judith [57200768752] [7202432925]

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