Demographics | Number | Percentage | |
---|---|---|---|
Total out of hospital cardiac arrests | 78 | Ā | |
āMales (mean age 61.5Ā yrs, range 18ā84, SD Ā± 14.9) | 63 | 80.8% | |
āFemale (mean age 63.4Ā yrs, range 34ā91, SD Ā± 16.9) | 15 | 19.2% | |
āTotal number of patients with AMI | 51 | 65.4% | |
āāSTEMI subgroup | 31 | 39.7% | |
āāNSTEMI subgroup | 20 | 25.6% | |
Transfers from peripheral hospitals | 46 | 59.0% | |
Direct presentations to TPCH | 32 | 41.0% | |
All coronary angiograms during the same period | 6072 | Ā | |
āMale | 4048 | 66.6% | |
ā- Mean age (in years) | 63.0 | Ā | |
āFemale | 2024 | 33.3% | |
ā- Mean age (in years) | 64.8 | Ā | |
All STEMI patientsa | 512 | Ā | |
āMale | 389 | 76.0% | |
ā- Mean age (years) | 59.0 | Ā | |
āFemale | 123 | 24.0% | |
ā- Mean age (years) | 64.2 | Ā | |
Mean body mass index (BMI) kg/m2 (Range 18.8ā55.6, SD Ā± 5.5) | 28.5 | Ā | |
Aboriginal or Torres Strait Island origin | 1 | 1.3% | |
Risk factors | Ā | Ā | |
Hypertension | 39/77 | 50.6% | |
Hyperlipidaemia | 28/67 | 41.8% | |
Diabetes | 13/77 | 16.9% | |
Current smoker | 22/62 | 35.5% | |
Any history of smoking | 47/59 | 79.7% | |
Known history of ischaemic heart disease | 20/76 | 26.3% | |
History of previous myocardial infarction | 17/76 | 22.4% | |
Documentation of illicit drug use at time of cardiac arrest | 3/75 | 4.0% | |
History of cardiomyopathy | 8/77 | 10.4% | |
Family history of ischaemic heart disease | 23/41 | 56.1% | |
Renal failure (GFR <60Ā ml/min) | 34/78 | 43.6% | |
Events immediately following cardiac arrest | Ā | Ā | |
Chest pain prior to event | 25/75 | 33.3% | |
Treatment (at the scene): CPR | 71/77 | 92.2% | |
āāāāāāāāāāĀ DCCV | 69/78 | 88.5% | |
Median time (in min) to ROSC (nā=ā67), IQR 10.0ā27.5 | 15.0 | Ā | |
Patients with initial treatment at a peripheral hospital | 46/78 | 59.0% | |
Thrombolysis in ambulance (of the 30 STEMI patients) | 2/78 | 2.2% | |
Initial rhythm by ambulance | Ventricular fibrillation | 59/78 | 75.6% |
Ventricular tachycardia | 6/78 | 7.7% | |
Asystole | 4/78 | 5.1% | |
Pulseless electrical activity | 4/78 | 5.1% | |
Bradycardia | 4/78 | 5.1% | |
Sinus rhythm | 1/78 | 1.3% | |
Unknown | 0/78 | 0.0% | |
Ambulance ECG after ROSC | Unclear | 4/60 | 6.7% |
Atrial fibrillation | 6/60 | 10.0% | |
Idioventricular rhythm | 2/60 | 3.3% | |
Junctional rhythm | 4/60 | 6.7% | |
Sinus rhythm | 43/60 | 71.7% | |
Ventricular tachycardia (unavailable and undocumented in 18 patients) | 1/60 | 1.7% | |
GCS | GCS 3 on arrival of paramedics at the scene | 62/77b | 80.5% |
Brought to hospital intubated or GCS 3 | 62/78 | 79.5% | |
Characteristics in the emergency department | Ā | Ā | |
Congestive heart failure | 11/78 | 11.8% | |
Abnormal left ventricular (LV) functionc | 52/72 | 72.2% | |
Cardiogenic shock | 34/78 | 43.6% | |
Requirement for inotropes | 35/78 | 44.9% | |
Intubation at any time during the first 24Ā hours | 67/78d | 85.9% | |
Insertion of balloon pump | 22/78 | 28.2% | |
First ECG in hospital | Ā | Ā | |
Rhythm: | Sinus rhythm | 66/78 | 84.6% |
Atrial fibrillation | 6/78 | 7.7% | |
Ventricular tachycardia | 3/78 | 3.8% | |
Ventricular fibrillation | 0/78 | 0.0% | |
Pulseless electrical activity | 1/78 | 1.3% | |
Junctional rhythm | 2/78 | 2.6% | |
Specific ECG changes (ST elevation or depression) | 43/78 | 55.1% | |
Any ST segment changes (including non-specific) | 63/78 | 80.8% | |
Normal ECG | 15/78 | 19.2% | |
QRS duration >120Ā ms | 15/78 | 19.2% | |
Myocardial territories identified on ECGe | Anterior | 21/43 | 48.8% |
Inferior | 7/43 | 16.3% | |
Lateral | 5/43 | 11.6% | |
Antero-lateral | 6/43 | 14.0% | |
Infero-lateral | 4/43 | 9.3% | |
Initial treatment in ami patient subgroup | Ā | Ā | |
Heparin or Enoxaparin | 48/51 | 94.1% | |
āHeparin | 42/51 | 82.4% | |
āEnoxaparin | 6/51 | 11.8% | |
Aspirin | 49/51 | 96.1% | |
Clopidogrel | 40/51 | 78.4% | |
Glycoprotein IIb IIIA receptor blocker | 9/51 | 17.6% | |
Thrombolysis (by ambulance or hospital) | Ā | Ā | |
āAs a proportion of all AMI patients | 10/51 | 19.6% | |
āFor patients with ST elevation on ECG | 10/32 | 31.3% | |
Timing of coronary angiogram | Ā | Ā | |
Emergent angiogram in entire group | 34/78 | 43.6% | |
Emergent angiogram in TPCH presentations | 22/32 | 68.8% | |
Emergent angiogram in peripheral hospital presentations | 12/46 | 26.1% |