Epidemiology, etiology, and outcomes of out-of-hospital cardiac arrest in young patients in lebanon

Abstract

Background: The burden of out-of-hospital cardiac arrest (OHCA) on different population segments in developing countries is not well studied. Previous studies from Lebanon report poor survival to hospital discharge (4.8%-5.5%). This study describes characteristics and outcomes of young OHCA victims in Beirut, Lebanon. Methods: This retrospective observational study included young patients (<35 years of age) with OHCA admitted to the emergency department (ED) of a tertiary care center in Lebanon over a 10-year period. Results: Fifty-four patients with OHCA were identified. Most were males (74.1%, n = 40) and the mean age was 17.9 ± 10.9 years. The most common arrest location was home (44.4%, n = 24). The majority were witnessed (78.8%, n = 41) with 15.4% (n = 8) witnessed by emergency medical services (EMS). Prehospital cardiopulmonary resuscitation was done for 22 patients (41.5%) mostly by EMS (n = 19, 86.4%), 9.1% (n = 2) by a bystander, and 4.5% (n = 1) by a family member. Prehospital automated external defibrillator use was documented in 13% (n = 7) of cases. Most patients (n = 48, 88.9%) were resuscitated in the ED where the most common rhythm was asystole (55.6%, n = 30). Half of the patients (50%, n = 27) survived to hospital admission. Overall survival to hospital discharge was 16.7% (n = 9). Good neurologic outcome (cerebral performance category 1 or 2) was documented in seven patients (9.3%). Conclusion: Survival rate of young OHCA victims in Lebanon (16.7%) is higher than previously reported rates of OHCA in the overall population. Targeted community activities and medical oversight of EMS activities are needed to link EMS activities to clinical outcomes. © 2019 Wiley Periodicals, Inc.