CoChat
Sign Up
Cited by 557Cardiac Arrest and ResuscitationPalliative Care and End-of-Life IssuesMechanical Circulatory Support Devices

Out-of-hospital cardiac arrest across the World: first report from the International Liaison Committee on Resuscitation (ILCOR)

Open access
Kiguchi, Tekeyuki, Okubo, Masashi, Nishiyama, Chika, Maconochie, Ian, Ong, Marcus Eng Hock, Kern, Karl B., Wyckoff, Myra H., McNally, Bryan +18 more·2020·Resuscitation
DOI 10.1016/j.resuscitation.2020.02.044
Open this paper in CoChat — free accountOpen PDF

Abstract

Background Since development of the Utstein style recommendations for the uniform reporting of cardiac arrest, increasing numbers of national and regional out-of-hospital cardiac arrest (OHCA) registries have been established worldwide. The International Liaison Committee on Resuscitation (ILCOR) created the Research and Registries Working Group and aimed to systematically report data collected from these registries. Methods We conducted two surveys of voluntarily participating national and regional registries. The first survey aimed to identify which core elements of the current Utstein style for OHCA were collected by each registry. The second survey collected descriptive summary data from each registry. We chose the data collected for the second survey based on the availability of core elements identified by the first survey. Results Seven national and four regional registries were included in the first survey and nine national and seven regional registries in the second survey. The estimated annual incidence of emergency medical services (EMS)-treated OHCA was 30.0-97.1 individuals per 100,000 population. The combined data showed the median age varied from 64 to 79 years and more than half were male in all 16 registries. The provision of bystander cardiopulmonary resuscitation (CPR) and bystander automated external defibrillator (AED) use was 19.1-79.0% in all registries and 2.0-37.4% among 11 registries, respectively. Survival to hospital discharge or 30-day survival after EMS-treated OHCA was 3.1-20.4% across all registries. Favorable neurological outcome at hospital discharge or 30 days after EMS-treated OHCA was 2.8-18.2%. Survival to hospital discharge or 30-day survival after bystander-witnessed shockable OHCA ranged from 11.7% to 47.4% and favorable neurological outcome from 9.9% to 33.3%. Conclusion This report from ILCOR describes data on systems of care and outcomes following OHCA from nine national and seven regional registries across the world. We found variation in reported survival outcomes and other core elements of the current Utstein style recommendations for OHCA across nations and regions.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.resuscitation.2020.02.044

Cites

3 of 3 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Deferred consent is considered as an ethically acceptable alternative for low-risk research, ensuring both the possibility of research benefit and respect for patient/family autonomy.

    “This is considered as an ethically acceptable alternative for low-risk research, ensuring both the possibility of research benefit and respect for patient/family autonomy. 325,326”

    From European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions (2021) · cites this paper as [325]

    The Methods describe surveys of cardiac-arrest registries, and the Discussion addresses differences in resuscitation practices and outcomes; neither addresses deferred consent. Searches for deferred consent, low-risk research, and patient or family autonomy found no relevant passage in our copy. No page numbers were available for these passages. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 48

  1. Berdowski J, Berg RA, Tijssen JGP, Koster RW. Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation 2010;81:1479À87.
  2. Gräsner J-T, Lefering R, Koster RW, et al. EuReCa ONE À 27 Nations, ONE Europe, ONE Registry. Resuscitation 2016;105:188À95.
  3. Nichol G, Thomas E, Callaway CW, et al. Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA 2008;300:1423À31.
  4. Girotra S, Diepen S, van Nallamothu BK, et al. Regional variation in out-of-hospital cardiac arrest survival in the United States. Circulation 2016;133:2159À68.
  5. Okubo M, Gibo K, Wallace DJ, et al. Regional variation in functional outcome after out-of-hospital cardiac arrest across 47 prefectures in Japan. Resuscitation 2018;124:21À8.
  6. Cummins RO, Chamberlain DA, Abramson NS, et al. Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. Circulation 1991;84:960À75.
  7. Jacobs I, Nadkarni V, Bahr J, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. Circulation 2004;110:3385À97.
  8. Jacobs I, Nadkarni V, Bahr J, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries. Resuscitation 2004;63:233À49.
  9. Perkins GD, Jacobs IG, Nadkarni VM, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein Resuscitation Registry Templates for out-of-hospital cardiac arrest. Resuscitation 2015;96:328À40.
  10. Kuisma M, Määttä T. Out-of-hospital cardiac arrests in Helsinki: Utstein style reporting. Heart 1996;76:18À23.
  11. Strömsöe A, Svensson L, Axelsson ÅB, Göransson K, Todorova L, Herlitz J. Validity of reported data in the Swedish Cardiac Arrest Register in selected parts in Sweden. Resuscitation 2013;84:952À6.
  12. Wissenberg M, Lippert FK, Folke F, et al. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA 2013;310:1377À84.
  13. Perkins GD, Brace-McDonnell SJ. The UK Out of Hospital Cardiac Arrest Outcome (OHCAO) project. BMJ Open 2015;5:e008736.
  14. Savastano S, Servi S, De Oltrona Visconti L, Raimondi M. The Pavia Cardiac Arrest REgistry À Pavia CARE, it's time for cardiologists to be engaged in cardiac arrest. Int J Cardiol 2015;185:93À4.
  15. Mauri R, Burkart R, Benvenuti C, et al. Better management of out-of- hospital cardiac arrest increases survival rate and improves neurological outcome in the Swiss Canton Ticino. Europace 2016;18:398À404.
  16. McNally B, Stokes A, Crouch A, Kellermann AL. CARES: cardiac arrest registry to enhance survival. Ann Emerg Med 2009;54:674À83.
  17. Bobrow BJ, Vadeboncoeur TF, Clark L, Chikani V. Establishing Arizona's statewide cardiac arrest reporting and educational network. Prehospital Emerg Care 2008;12:381À7.
  18. Morrison LJ, Nichol G, Rea TD, et al. Rationale, development and implementation of the resuscitation outcomes consortium epistry- cardiac arrest. Resuscitation 2008;78:161À9.
  19. Lin S, Morrison LJ, Brooks SC. Development of a data dictionary for the Strategies for Post Arrest Resuscitation Care (SPARC) network for post cardiac arrest research. Resuscitation 2011;82:419À22.
  20. Ong MEH, Shin S, Do Tanaka H, et al. Pan-Asian Resuscitation Outcomes Study (PAROS): rationale, methodology, and implementation. Acad Emerg Med 2011;18:890À7.
  21. Kitamura T, Iwami T, Kawamura T, et al. Nationwide public-access defibrillation in Japan. N Engl J Med 2010;362:994À1004.
  22. Beck B, Bray J, Smith K, et al. Establishing the Aus-ROC Australian and New Zealand out-of-hospital cardiac arrest epistry. BMJ Open 2016;6:e011027.
  23. Beck B, Bray J, Cameron P, et al. Regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest in Australia and New Zealand: results from the Aus-ROC epistry. Resuscitation 2018;126:49À57.
  24. Dyson K, Brown SP, May S, et al. International variation in survival after out-of-hospital cardiac arrest: a validation study of the Utstein template. Resuscitation 2019;138:168À81.
  25. Perkins GD, Neumar R, Monsieurs KG, et al. The International Liaison Committee on Resuscitation À review of the last 25 years and vision for the future. Resuscitation 2017;121:104À16.
  26. Buick JE, Drennan IR, Scales DC, et al. Improving temporal trends in survival and neurological outcomes after out-of-hospital cardiac arrest. Circ Cardiovasc Qual Outcomes 2018;11:e003561.
  27. Brooks SC, Schmicker RH, Cheskes S, et al. Variability in the initiation of resuscitation attempts by emergency medical services personnel during out-of-hospital cardiac arrest. Resuscitation 2017;117:102À8.
  28. Sasson C, Rogers MAM, Dahl J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest a systematic review and meta- analysis. Circ Cardiovasc Qual Outcomes 2010;3:63À81.
  29. Nakahara S, Tomio J, Ichikawa M, et al. Association of bystander interventions with neurologically intact survival among patients with bystander-witnessed out-of-hospital cardiac arrest in Japan. JAMA 2015;314:247.
  30. Hasselqvist-Ax I, Riva G, Herlitz J, et al. Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest. N Engl J Med 2015;372:2307À15.
  31. Holmberg MJ, Vognsen M, Andersen MS, Donnino MW, Andersen LW. Bystander automated external defibrillator use and clinical outcomes after out-of-hospital cardiac arrest: a systematic review and meta-analysis. Resuscitation 2017;120:77À87.
  32. Kitamura T, Kiyohara K, Sakai T, et al. Public-access defibrillation and out- of-hospital cardiac arrest in Japan. N Engl J Med 2016;375:1649À59.
  33. Hallstrom A, Ornato J, Weisfeldt M, et al. Public-access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med 2004;371:637À46.
  34. Weisfeldt ML, Sitlani CM, Ornato JP, et al. Survival after application of automatic external defibrillators before arrival of the emergency medical system: evaluation in the resuscitation outcomes consortium population of 21 million. J Am Coll Cardiol 2010;55:1713À20.
  35. Böttiger BW, Van Aken H. Training children in cardiopulmonary resuscitation worldwide. Lancet 2015;385:2353À4.
  36. Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD. Hands- only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest À a science advisory for the public from the American heart association emergency cardiovas. Circulation 2008;117:2162À7.
  37. Wu Z, Panczyk M, Spaite DW, et al. Telephone cardiopulmonary resuscitation is independently associated with improved survival and improved functional outcome after out-of-hospital cardiac arrest. Resuscitation 2018;122:135À40.
  38. Ro YS, Shin S, Do Lee YJ, et al. Effect of dispatcher-assisted cardiopulmonary resuscitation program and location of out-of-hospital cardiac arrest on survival and neurologic outcome. Ann Emerg Med 2017;69:52À61.
  39. Rea TD, Eisenberg MS, Culley LL, Becker L. Dispatcher-assisted cardiopulmonary resuscitation and survival in cardiac arrest. Circulation 2001;104:2513À6.
  40. Brooks SC, Simmons G, Worthington H, Bobrow BJ, Morrison LJ. The pulsepoint respond mobile device application to crowdsource basic life support for patients with out-of-hospital cardiac arrest: challenges for optimal implementation. Resuscitation 2016;98:20À6.
  41. Ringh M, Rosenqvist M, Hollenberg J, et al. Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest. N Engl J Med 2015;372:2316À25.
  42. Caputo ML, Muschietti S, Burkart R, et al. Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: a comparison with SMS-based system notification. Resuscitation 2017;114:73À8.
  43. Nishiyama C, Brown SP, May S, et al. Apples to apples or apples to oranges? International variation in reporting of process and outcome of care for out-of-hospital cardiac arrest. Resuscitation 2014;85:1599À609.
  44. Nolan JP, Soar J, Cariou A, et al. European Resuscitation Council and European Society of Intensive Care Medicine Guidelines for Post- resuscitation Care 2015, Section 5 of the European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation 2015;95:202À22.
  45. Callaway CW, Donnino MW, Fink EL, et al. Part 8: Post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2015;132:S465À82.
  46. Rea TD, Cook AJ, Stiell IG, et al. Predicting survival after out-of- hospital cardiac arrest: role of the Utstein data elements. Ann Emerg Med 2010;55:249À57.
  47. Cummins RO, Chamberlain D, Hazinski MF, et al. Recommended guidelines for reviewing, reporting, and conducting research on in- hospital resuscitation: the in-hospital "Utstein style". Resuscitation 1997;34:151À83.
  48. Cummins RO, Chamberlain D, Hazinski MF, et al. Recommended guidelines for reviewing, reporting, and conducting research on in- hospital resuscitation: the in-hospital 'Utstein Style'. Circulation 1997;95:2213À39.

Cited by

Sorted by citations

Authors
Kiguchi, T., Okubo, M., Nishiyama, C., Maconochie, I., Ong, M. E. H., Kern, K. B., Wyckoff, M. H., McNally, B., Christensen, E. F., Tjelmeland, I., Herlitz, J., Perkins, G. D., Booth, S., Finn, J., Shahidah, N., Shin, S. D., Bobrow, B. J., Morrison, L. J., Salo, A., Baldi, E., Burkart, R., Lin, C.-H., Jouven, X., Soar, J., Nolan, J. P., & Iwami, T.
Affiliations
  • University of Pittsburgh (US)
  • Kyoto University (JP)
  • Imperial College London (GB)
  • Singapore General Hospital (SG)
  • University of Arizona (US)
  • The University of Texas Southwestern Medical Center (US)
  • Emory University (US)
  • Aalborg University Hospital (DK)
  • Oslo University Hospital (NO)
  • Sahlgrenska University Hospital (SE)
  • University Hospitals Birmingham NHS Foundation Trust (GB)
  • University of Warwick (GB)
  • The University of Western Australia (AU)
  • Seoul National University (KR)
  • The University of Texas Health Science Center at Houston (US)
  • St. Michael's Hospital (CA)
  • University of Helsinki (FI)
  • University of Pavia (IT)
  • National Cheng Kung University Hospital (TW)
  • Assistance Publique – Hôpitaux de Paris (FR)
  • North Bristol NHS Trust (GB)
  • Royal United Hospital (GB)
Corresponding author
Iwami, Taku
ORCID
Venue
Resuscitation
Publisher
Elsevier BV
Published
2020-07
Volume
152
Pages
39-49
ISSN
0300-9572 (ISSN-L)
DOI
10.1016/j.resuscitation.2020.02.044
OpenAlex
W3015600534
Cited by
557
References
3
Citations by year
2026: 63 · 2025: 86 · 2024: 121 · 2023: 98 · 2022: 85 · 2021: 80 · 2020: 24
FWCI
69.08
Type
journal article
Language
en
Open access
Licence
Locations
  • Resuscitation (publishedVersion)
  • PubMed (publishedVersion)
  • Warwick Research Archive Portal (University of Warwick) (acceptedVersion)
  • Monash University Research Portal (Monash University) (submittedVersion, other-oa)
  • UWA Profiles and Research Repository (UWA) (submittedVersion)
  • eSpace (Curtin University) (submittedVersion, cc-by-nc-nd)
  • Työväentutkimus Vuosikirja (submittedVersion)
  • VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
  • Bristol Research (University of Bristol) (submittedVersion)
  • Explore Bristol Research (submittedVersion)
Funders
  • American Heart Association
  • Japan Resuscitation Council
Topics
  • Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Physical Sciences › Engineering › Biomedical Engineering › Mechanical Circulatory Support Devices
Keywords
out-of-hospital cardiac arrest, cardiac arrest registry, incidence, bystander CPR, automated external defibrillator use, survival to hospital discharge, neurological outcome, systems of care
MeSH terms
Aged, Emergency Medical Services, Female, Humans, Male, Middle Aged, Registries, Cardiopulmonary Resuscitation, Defibrillators, Out-of-Hospital Cardiac Arrest

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review