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J Am Coll Cardiol, 1997; 30:1500-1505
© 1997 by the American College of Cardiology Foundation
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Out-of-hospital cardiac arrest in the 1990's: a population-based study in the Maastricht area on incidence, characteristics and survival

JJ de Vreede-Swagemakers, AP Gorgels, WI Dubois-Arbouw, JW van Ree, MJ Daemen, LG Houben, and HJ Wellens

Department of Cardiology, University of Limburg, Maastricht, The Netherlands.

OBJECTIVES: We sought to describe the incidence, characteristics and survival of out-of-hospital sudden cardiac arrest (SCA) in the Maastricht area of The Netherlands. BACKGROUND: Incidence and survival rates of out-of-hospital SCA in different communities are often based on the number of victims resuscitated by the emergency medical services. Our population-based study in the Maastricht area allows information on all victims of witnessed and unwitnessed SCA occurring outside the hospital. METHODS: Incidence, patient characteristics and survival rates were determined by prospectively collecting information on all cases of SCA occurring in the age group 20 to 75 years between January 1, 1991 and December 31, 1994. Survival rates were related to the site of the event (at home vs. outside the home) and the presence or absence of a witness and rhythm at the time of the resuscitation attempt in out-of-hospital SCA. RESULTS: Five hundred fifteen patients were included (72% men, 28% women). In 44% of men and 53% of women, SCA was most likely the first manifestation of heart disease. In patients known to have had a previous myocardial infarction (MI), the mean interval between the MI and SCA was 6.5 years, with >50% having a left ventricular ejection fraction >30%. The mean yearly incidence of SCA was 1 in 1,000 inhabitants. Of all deaths in the age groups studied, 18.5% were sudden. Nearly 80% of SCAs occurred at home. In 60% of all cases of SCA a witness was present. Cardiac resuscitation, which was attempted in 51% of all subjects, resulted overall in 32 (6%) of 515 patients being discharged alive from the hospital. Survival rates for witnessed SCA were 8% (16 of 208 subjects) at home and 18% (15 of 85 subjects) outside the home (95% confidence interval 1% to 18.8%). CONCLUSIONS: The majority of victims of SCA cannot be identified before the event. Sudden cardiac arrest usually occurs at home, and the survival of those with a witnessed SCA at home was low compared with that outside the home, indicating the necessity of optimizing out-of-hospital resuscitation, especially in the at-home situation.


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S.G. Priori, E. Aliot, C. Blomstrom-Lundqvist, L. Bossaert, G. Breithardt, P. Brugada, A.J. Camm, R. Cappato, S.M. Cobbe, C. Di Mario, et al.
Task Force on Sudden Cardiac Death of the European Society of Cardiology
Eur. Heart J., August 2, 2001; 22(16): 1374 - 1450.
[PDF]


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Postgrad. Med. J.Home page
P Mazeika
Aborted sudden cardiac death: a clinical perspective
Postgrad. Med. J., June 1, 2001; 77(908): 363 - 370.
[Abstract] [Full Text]


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Cardiovasc ResHome page
N. Sotoodehnia, A. Zivin, G. H Bardy, and D. S Siscovick
Reducing mortality from sudden cardiac death in the community: lessons from epidemiology and clinical applications research
Cardiovasc Res, May 1, 2001; 50(2): 197 - 209.
[Abstract] [Full Text] [PDF]


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ChestHome page
M. H. Gollob and J. J. Seger
Current Status of the Implantable Cardioverter-Defibrillator
Chest, April 1, 2001; 119(4): 1210 - 1221.
[Abstract] [Full Text] [PDF]


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HeartHome page
L H Soo, D Gray, T Young, and J R Hampton
Circadian variation in witnessed out of hospital cardiac arrest
Heart, October 1, 2000; 84(4): 370 - 376.
[Abstract] [Full Text]


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Eur Heart JHome page
G. Fontaine, P. Fornes, and F. Fontaliran
Hearts 'too bad' to survive 'too good' to die
Eur. Heart J., August 1, 2000; 21(15): 1209 - 1211.
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StrokeHome page
N. R. Grubb, K. A. A. Fox, K. Smith, J. Best, A. Blane, K. P. Ebmeier, M. F. Glabus, and R. E. O'Carroll
Memory Impairment in Out-of-Hospital Cardiac Arrest Survivors Is Associated With Global Reduction in Brain Volume, Not Focal Hippocampal Injury
Stroke, July 1, 2000; 31(7): 1509 - 1514.
[Abstract] [Full Text] [PDF]


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NEJMHome page
A. E. Buxton, K. L. Lee, L. DiCarlo, M. R. Gold, G. S. Greer, E. N. Prystowsky, M. F. O'Toole, A. Tang, J. D. Fisher, J. Coromilas, et al.
Electrophysiologic Testing to Identify Patients with Coronary Artery Disease Who Are at Risk for Sudden Death
N. Engl. J. Med., June 29, 2000; 342(26): 1937 - 1945.
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QJMHome page
N.R. GRUBB and P. BLOOMFIELD
Cheating sudden death: how to do it, and what life's like after it
QJM, March 1, 2000; 93(3): 191 - 195.
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NEJMHome page
A. E. Buxton, K. L. Lee, J. D. Fisher, M. E. Josephson, E. N. Prystowsky, G. Hafley, and The Multicenter Unsustained Tachycardia Trial Inve
A Randomized Study of the Prevention of Sudden Death in Patients with Coronary Artery Disease
N. Engl. J. Med., December 16, 1999; 341(25): 1882 - 1890.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
A. E. Epstein, J. Powell, Q. Yao, C. Ocampo, S. Lancaster, Y. Rosenberg, D. S. Cannom, J. M. Herre, H. L. Greene, and the AVID Investigators
In-hospital versus out-of-hospital presentation of life-threatening ventricular arrhythmias predicts survival: Results from the AVID registry
J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1111 - 1116.
[Abstract] [Full Text] [PDF]


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CirculationHome page
X. Jouven, M. Desnos, C. Guerot, and P. Ducimetiere
Predicting Sudden Death in the Population : The Paris Prospective Study I
Circulation, April 20, 1999; 99(15): 1978 - 1983.
[Abstract] [Full Text] [PDF]


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CirculationHome page
D. P. Zipes and H. J. J. Wellens
Sudden Cardiac Death
Circulation, November 24, 1998; 98(21): 2334 - 2351.
[Full Text] [PDF]


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HeartHome page
J J M de Vreede-Swagemakers, A P M Gorgels, W I Dubois-Arbouw, J Dalstra, M J A P Daemen, J W van Ree, R E Stijns, and H J J Wellens
Circumstances and causes of out-of-hospital cardiac arrest in sudden death survivors
Heart, April 1, 1998; 79(4): 356 - 361.
[Abstract] [Full Text]



 
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