Paro cardíaco extrahospitalario en el departamento de Maldonado, Uruguay: Análisis de cinco años

Federico Machado; Álvaro Niggemeyer; Henry Albornoz

Authors

Federico Machado Universidad de la República, Facultad de Medicina, Departamento de Cardiología. Cardiólogo
Álvaro Niggemeyer Universidad de la República, Facultad de Medicina, Hospital de Clínicas, Departamento de Emergencia. Profesor Adjunto
Henry Albornoz Fondo Nacional de Recursos. Médico Asistente, Intensivista e Infectólogo

Keywords:

OUT OF HOSPITAL CARDIAC ARREST

Abstract

Objective: to describe and analyse the presentation, treatment and evolution until hospitalization, of patients treated for out-of-hospital cardiac arrest by an emergency ambulance service in Maldonado, Uruguay.
Method: a descriptive-analytical, retrospective study of all patients who suffered from out-of-hospital cardiac arrest and were treated by an emergency ambulance service from January 2005 through June 2010.
Results: 169 non-traumatic cases of out-of-hospital cardiac arrest in adults were analysed. Average age was 66.9 years old, 70.4% were men. Seventy point four per cent occurred in the patients' domicile. Response time was 6 minutes. Cardiopulmonary resuscitation maneuvers (CRM) were applied to 39.6% of patients prior to their arriving at the hospital. The most frequent heart rate upon arrival was asystole (57.4%), followed by ventricular fibrillation (26.6%). Return to spontaneous circulation was achieved in 30.2% of patients and survival upon hospitalization was 22.5%.
Out of hospital cardiac arrest in non- shockable ryhtms was associated to return to spontaneous circulation (43.5% versus 25.2% p=0,021). Out of hospital cardiac arrest in the streets was associated to greater survival rates upon hospitalization (39.1% versus 19.9%, p=0,04). Combination of out of hospital cardiac arrest in the streets and non-shockable rythms was associated to return to spontaneous circulation (71.4% versus 28.4%, p=0,027) and greater survival upon hospitalization (57.1% versus 21%, p=0.046).
Conclusions: response time of emergency ambulance services was good when compared to international figures. Out-of-hospital cardiac arrest in the street and with non-shockable rythms was associated to better prognosis. Results in terms of return to spontaneous circulation and survival upon hospitalization were comparable to what is internationally reported.

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