Akademik Veri Yönetim Sistemi
Anatolian Journal of Emergency Medicine, cilt.8, sa.4, ss.150-157, 2025 (TRDizin)
Aim: This study aims to examine prehospital and hospital factors influencing survival outcomes of out-of-hospital cardiac arrest (OHCA) patients in a developing Emergency Medical Services (EMS) context.
Material and Methods: This retrospective cohort study included OHCA patients (≥18 years) from January 1, 2021, to December 31, 2024, at Lokman Hekim University Ankara Hospital. Patients were divided into four groups according to their survival status; those who survived in the emergency department (Group I), those who did not survive in the emergency department (Group II), those who survived in the hospital (Group III), and those who did not survive in the hospital (Group IV).
Results: A total of 644 patients were included. The survival rate in the ED was 52.2%, while the overall survival rate was 6.4%. Significant univariate predictors of emergency department (ED) survival included shorter time to return of spontaneous circulation (ROSC), lower initial lactate levels, shockable first arrest rhythm, witnessed arrest, and location of the arrest. Bystander CPR was also strongly associated with ED survival in univariate analysis (p < 0.001), although it did not reach statistical significance in the multivariate model (p = 0.066). In contrast, both shorter time to ROSC (p < 0.001) and lower lactate levels (p < 0.001) remained independent predictors of ED survival in the multivariate regression analysis.
Conclusion: Prehospital factors, such as timely CPR and EMS response times, significantly influence OHCA survival rates. While bystander CPR plays a critical role, optimizing EMS response time and reducing prehospital delays are essential for improving outcomes. Further studies are needed to refine EMS protocols and enhance survival prospects in OHCA patients.