General practitioner contribution to out-of-hospital cardiac arrest outcome: A national registry study. (June 2015)

• Record Type: Journal Article
• Authors: Masterson, Siobhán; Vellinga, Akke; Wright, Peter; Dowling, John; Bury, Gerard; Murphy, Andrew W
• Is Part Of: European journal of general practice. Volume 21:Number 2(2015:Jun.)
• Page Start: 131
• Page End: 137
• Publication Date: 2015-06
• Subjects: Family medicine -- Periodicals; 362.172
• DOI: 10.3109/13814788.2014.962509
• Languages: English
• ISSNs: 1381-4788

Abstract

<abstract> <title>Abstract</title> <p> <bold>Background:</bold> There is a wide variation in reported survival from out-of-hospital cardiac arrest (OHCA). One factor in this variation may be the contribution of general practitioners to pre-hospital resuscitation. Studies using self-reported data describe increased survival proportions when general practitioners are involved.</p> <p> <bold>Objectives:</bold> This study aims to investigate the contribution of general practitioner involvement in out-of-hospital cardiac arrest events.</p> <p> <bold>Design and Setting:</bold> A retrospective observational study using data collected from ambulance records in the Republic of Ireland to describe general practitioner (GP) contribution to pre-hospital resuscitation attempts (<italic>n</italic> = 2369). Analysis is limited to patients with presumed cardiac cause and first arrest rhythm recorded as shockable (<italic>n</italic> = 510).</p> <p> <bold>Results:</bold> When a GP is present at scene (<italic>n</italic> = 199) patients are less likely to achieve return of spontaneous circulation (ROSC) (<italic>P</italic> < 0.001) or be transported to hospital (<italic>P</italic> < 0.001). When GPs participate in resuscitation (<italic>n = </italic>92), patients are more likely to have collapsed in a public place (<italic>P</italic> < 0.01), receive bystander CPR (<italic>P</italic> < 0.001) and survive to hospital discharge (<italic>P</italic> < 0.001). Multiple logistic analysis of survival suggests that GP participation in resuscitation increases the odds of survival (4.6; 95% CI 1.6–13.3) and having collapsed in a public place increases chances of survival (5.8; 95% CI 2.1–15.7).</p> <p> <bold>Conclusion:</bold> Our analysis suggests that in this subgroup, GP participation in OHCA resuscitation attempts is associated with improved patient survival. Furthermore, resuscitation is more likely to be ceased at scene when a GP is present, highlighting the role that GPs play in the compassionate management of death in unviable circumstances.</p> </abstract>