Background:

Effective lay resuscitation is essential for patients with out-of-hospital cardiac arrest (OHCA). Data on patients admitted to PCI-centers after OHCA are scarce.

Methods: 

All consecutive patients admitted after OHCA to our overregional PCI-center between 01/2017 – 09/2020 were documented in a prospective registry.

Data analysis had two major study hypotheses: 1) In patients with known heart diseases a higher rate of lay resuscitations is observed compared to patients without known heart diseases due to a better education of the environment of the patients; 2) In patients with good outcome an elevated rate of lay resuscitations is observed compared to patients with poor outcome.

Results:

Out of 551 documented patients 414 (75,1%) were male, mean age was 64,6 ± 13,4 years. In 49,4% OHCA was at the home of the patients. In 64,2% ventricular fibrillation was the first recorded rhythm. Lay resuscitation was performed in 47,7% of the patients, while in 36,7% no lay resuscitation was performed and in 15,6% medical professionals were present at begin of OHCA. 

In 182 patients (33%) heart diseases were already known before resuscitation (mostly coronary artery disease). The rate of patients without lay resuscitations was not different in patients with or without known heart diseases (36,3% vs. 36.7%, p = n.s., Figure 1). 

At hospital, coronary angiography was performed in nearly all patients at our PCI-center (n=526, 95,5%). In 352 patients (63,9%) significant coronary artery disease was diagnosed as cause of OHCA, PCI was performed in 295 patients (53,5%).

54,0% of the patients died in hospital, 9,4% were discharged with relevant neurological deficit, 36,6% were discharged alive and without neurological deficit. Comparing patients with good outcome (alive, no neurological deficit) to patients with poor outcome (death or neurological deficits) the rate of lay resuscitations was not significantly different between the groups (57,2% vs. 54,4%, p = n.s.).

Conclusion 

The study shows that intensified public education on lay resuscitation is needed:

The rate of lay resuscitation was not elevated in patients with known heart diseases, although the environment of these patients with elevated risk should have received education. 

The rate of lay resuscitation was not elevated in patients with good outcome, indicating that in clinical practice performance of lay resuscitation is often not effective enough.