Background

Several data have been published about the demographics and state of resuscitation of young patients suffering from sudden cardiac death (SCD). However, data about state of resuscitation (e.g. time, location of resuscitation) in Germany are sparse.

Methods

Clinical data were screened for patients admitted at the Bergmannsheil University Medical Center from 2010-to 2021. All patients suffering from cardiac arrest at age<65 years were included. The baseline characteristics, related causes of SCD, treatment approaches and outcome were studied.

Results

235 patients (median age 56 (16-65) years, 82.1% males) were identified in the clinic database. The first documented rhythm was ventricular fibrillation in 69.2%, asystole 18.3%, pulses electrical activity 4%, ventricular tachycardia 5.4% and bradycardia 2.7%. The first body temperature was at median 36.3°C (min-max. 31.8-38.7). Location of cardiac arrest was at home (34%), workplace (12.8%), public place (26%), emergency ambulance (5.1%), hospital (17.9%) or other places (1.3%). Bystander-witnessed resuscitation was initiated in 85.5% and lay resuscitation in 39.8%. Time to start resuscitation was in 96.1% less than 10 minutes, 11-20 minutes (3.4%), 21-30 minutes (0.6%). The number of ICD shocks delivered were 3 (max-min 1-15). 7.9% suffered from cardiac arrest at rest, 10.1% during sport, 35.7% at non-stressful daily activities, 13.2% at working, and 33% at other scenarios. The mechanical assist device was used in 5.1%. 25.8% of patients received hypothermia treatment with a median time of hypothermia of 24 hours (6-24) and lowest achieved body-temperature of 33°C (max-min 32-36). The total duration time of resuscitation was at median 35  minutes. The in-hospital mortality rate was 46.6%.

Conclusions

Most patients admitted with cardiac arrest suffers from this situation at home and non-stressful daily activities. The outcome depends on treatment chain and a half of patients suffer from in-hospital mortality.