TY - JOUR
T1 - Characteristics and outcomes of out-of-hospital-cardiac-arrest in rural and suburban areas of Sindh, Pakistan
T2 - A cross-sectional study
AU - Noor Ali Baig, Mirza
AU - Fatmi, Zafar
AU - Khan, Nadeem Ullah
AU - Rahim Khan, Uzma
AU - Raheem, Ahmed
AU - Abdul Razzak, Junaid
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2025/1
Y1 - 2025/1
N2 - Background: Despite extensive research on OHCA in urban centres worldwide, there is a significant gap in knowledge regarding these events in less urbanized regions, especially in Low-Middle-Income Countries (LMICs). Aim: To determine the characteristics and outcomes of adult out-of-hospital cardiac arrest (OHCA) in rural and suburban districts of Sindh, Pakistan. Methods: Data of OHCA patients (>18 years) was collected retrospectively from January 2020 to December 2022, from the medical records of district and tehsil hospitals of the province of Sindh. Data analysis was performed using the Statistical Package Software for the Social Sciences (SPSS) Statistics 29. Results: Out of 139 OHCA patients, 75.5 % were males, and 24.5 % were females, with a mean age of 52.78 ± 13.1 years. Most cardiac arrests occurred at home (54.75 %). Only 0.7 % of patients were transported by emergency medical services (EMS), while 59 % arrived via private transport, such as cars or vans. An additional 4.3 % were brought by other ambulance services, including private and philanthropic organizations, and for 36 % of patients, the mode of transportation was undocumented. Cardiac arrests were witnessed in 43.2 % of cases. CPR (either in-hospital or pre-hospital) was performed on 59 % of patients, but only 6.1 % received pre-hospital CPR (Bystander: 1.22 %, Ambulance Staff: 2.44 %, Family Member: 2.44 %). Return of spontaneous circulation (ROSC) was achieved in 14.63 % of patients, while 4.88 % were alive at hospital admission. Conclusion: This study highlights significant gaps in the chain of survival for OHCA patients in rural and suburban Sindh, Pakistan, including inadequate EMS utilization, low bystander CPR rates, and delayed hospital care, contributing to poor outcomes. The findings may underestimate true rates due to missing and inconsistent data, emphasizing the need for improved documentation and prospective studies.
AB - Background: Despite extensive research on OHCA in urban centres worldwide, there is a significant gap in knowledge regarding these events in less urbanized regions, especially in Low-Middle-Income Countries (LMICs). Aim: To determine the characteristics and outcomes of adult out-of-hospital cardiac arrest (OHCA) in rural and suburban districts of Sindh, Pakistan. Methods: Data of OHCA patients (>18 years) was collected retrospectively from January 2020 to December 2022, from the medical records of district and tehsil hospitals of the province of Sindh. Data analysis was performed using the Statistical Package Software for the Social Sciences (SPSS) Statistics 29. Results: Out of 139 OHCA patients, 75.5 % were males, and 24.5 % were females, with a mean age of 52.78 ± 13.1 years. Most cardiac arrests occurred at home (54.75 %). Only 0.7 % of patients were transported by emergency medical services (EMS), while 59 % arrived via private transport, such as cars or vans. An additional 4.3 % were brought by other ambulance services, including private and philanthropic organizations, and for 36 % of patients, the mode of transportation was undocumented. Cardiac arrests were witnessed in 43.2 % of cases. CPR (either in-hospital or pre-hospital) was performed on 59 % of patients, but only 6.1 % received pre-hospital CPR (Bystander: 1.22 %, Ambulance Staff: 2.44 %, Family Member: 2.44 %). Return of spontaneous circulation (ROSC) was achieved in 14.63 % of patients, while 4.88 % were alive at hospital admission. Conclusion: This study highlights significant gaps in the chain of survival for OHCA patients in rural and suburban Sindh, Pakistan, including inadequate EMS utilization, low bystander CPR rates, and delayed hospital care, contributing to poor outcomes. The findings may underestimate true rates due to missing and inconsistent data, emphasizing the need for improved documentation and prospective studies.
KW - Bystanders
KW - CPR
KW - EMS
KW - Out-of-hospital-cardiac-arrest (OHCA)
UR - http://www.scopus.com/inward/record.url?scp=85212347201&partnerID=8YFLogxK
U2 - 10.1016/j.resplu.2024.100840
DO - 10.1016/j.resplu.2024.100840
M3 - Article
AN - SCOPUS:85212347201
SN - 2666-5204
VL - 21
JO - Resuscitation Plus
JF - Resuscitation Plus
M1 - 100840
ER -
