Prospective, multicenter, Turkish out‑of‑hospital cardiac arrest study: TROHCA

Alp Şener1; 2; Murat Pekdemir; Mehmet Muzaffer İslam; Ersin Aksay; Sevilay Karahan; Gokhan Aksel; Nurettin Özgür Doğan; Berkant Öztürk; Muhammet Hacımustafaoğlu; Çağrı Türkücü; Serkan Emre Eroğlu; Yusuf Yürümez; Nuray
Aslan; Necip Gokhan Güner; Neşe Nur User; Hüseyin Aldemir; Abdullah Sadik Girişgin; Sedat Koçak; Sami Ataman; Ayhan Özhasenekler1; 2; Gul Pamukçu Günaydın1; 2; Mustafa Burak Sayhan; Ömer Salt; Satuk Bugra Han Bozatlı; Engin Deniz Arslan; Fevzi Yılmaz; Ramazan Sivil; Özlem Köksal; Vahide Aslıhan Durak; Fatma Özdemir; Mahmut Taş; Yenal Karakoç; Öner Avınca; Yunus Emre Arık; Adem Melekoğlu; Özgür Çevrim; Özlem Yiğit; Cem Oktay; Süleyman İbze; Salim Satar; Muge Gülen; Selen Acehan; Erhan Altunbaş; Melis Efeoğlu Saçak; Emir Ünal; Erdem Çevik; Dilay Satılmış; Hande Asan; Yunus Karaca; Melih İmamoğlu; Vildan Özer; Ahmet Demircan; Ayfer Keleş; Gültekin Kadı; Orhan Delice; Sibel Güçlü Utlu; Senol Arslan; Neslihan Yücel; Şükrü Gürbüz; Hüseyin Burak Ayhan; Abdullah Şen; Mahmut Yaman; Müge Günalp; Sinan Genç; Ahmet Baydın; Fatih Çalışkan; Şeyma Arzu Temür; Murat Ersel; Sercan Yalçınlı; Enver Özçete; Bulent Erbil; Elif Ozturk Ince; Mehmet Ali Karaca; Murat Çetin; Mehmet Demirbağ; Mustafa Sabak; Mustafa Bozkurt

doi:10.4103/tjem.tjem_73_24

Alp Şener^1,2, Murat Pekdemir³, Mehmet Muzaffer İslam⁴, Ersin Aksay⁵, Sevilay Karahan⁶, Gokhan Aksel⁴, Nurettin Özgür Doğan³, Berkant Öztürk⁷, Muhammet Hacımustafaoğlu⁷, Çağrı Türkücü⁷, Serkan Emre Eroğlu⁴, Yusuf Yürümez⁸, Nuray Aslan⁸, Necip Gokhan Güner⁸, Neşe Nur User⁹, Hüseyin Aldemir⁹, Abdullah Sadik Girişgin¹⁰, Sedat Koçak¹⁰, Sami Ataman¹⁰, Ayhan Özhasenekler^1,2, Gul Pamukçu Günaydın^1,2, Mustafa Burak Sayhan¹¹, Ömer Salt¹¹, Satuk Bugra Han Bozatlı¹¹, Engin Deniz Arslan¹², Fevzi Yılmaz¹², Ramazan Sivil¹², Özlem Köksal¹³, Vahide Aslıhan Durak¹³, Fatma Özdemir¹³, Mahmut Taş¹⁴, Yenal Karakoç¹⁴, Öner Avınca¹⁴, Yunus Emre Arık¹⁵, Adem Melekoğlu¹⁵, Özgür Çevrim¹⁵, Özlem Yiğit¹⁶, Cem Oktay¹⁶, Süleyman İbze¹⁶, Salim Satar¹⁷, Muge Gülen¹⁷, Selen Acehan¹⁷, Erhan Altunbaş¹⁸, Melis Efeoğlu Saçak¹⁸, Emir Ünal¹⁸, Erdem Çevik¹⁹, Dilay Satılmış¹⁹, Hande Asan¹⁹, Yunus Karaca²⁰, Melih İmamoğlu²⁰, Vildan Özer²⁰, Ahmet Demircan²¹, Ayfer Keleş²¹, Gültekin Kadı²¹, Orhan Delice²², Sibel Güçlü Utlu²², Senol Arslan²², Neslihan Yücel²³, Şükrü Gürbüz²³, Hüseyin Burak Ayhan²³, Abdullah Şen²⁴, Mahmut Yaman²⁴, Müge Günalp²⁵, Sinan Genç²⁵, Ahmet Baydın²⁶, Fatih Çalışkan²⁶, Şeyma Arzu Temür²⁶, Murat Ersel²⁷, Sercan Yalçınlı²⁷, Enver Özçete²⁷, Bulent Erbil²⁸, Elif Ozturk Ince²⁸, Mehmet Ali Karaca²⁸, Murat Çetin²⁹, Mehmet Demirbağ³⁰, Mustafa Sabak³¹, Mustafa Bozkurt³¹

¹Department of Emergency Medicine, Ankara Bilkent City Hospital, Ankara, Türkiye
²Department of Emergency Medicine, Ankara Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Türkiye
³Department of Emergency Medicine, Kocaeli University, Faculty of Medicine, Kocaeli, Türkiye
⁴University of Health Sciences, Umraniye Training and Research Hospital, İstanbul, Türkiye
⁵Department of Emergency Medicine, İzmir Ekonomi University, Medical Point Hospital, Izmir, Türkiye
⁶Department of Biostatistics, Hacettepe University, Faculty of Medicine, Ankara, Türkiye
⁷Department of Emergency Medicine, Aksaray University, Aksaray Training and Research Hospital, Aksaray, Türkiye
⁸Department of Emergency Medicine, Sakarya University, Faculty of Medicine, Sakarya, Türkiye
⁹Department of Emergency Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Türkiye
¹⁰Department of Emergency Medicine, Necmettin Erbakan University, Faculty of Medicine, Konya, Türkiye
¹¹Department of Emergency Medicine, Trakya University, Faculty of Medicine, Edirne, Türkiye
¹²Department of Emergency Medicine, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye
¹³Department of Emergency Medicine, Bursa Uludağ University, Faculty of Medicine, Bursa, Türkiye
¹⁴Department of Emergency Medicine, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye
¹⁵Department of Emergency Medicine, University of Health Sciences, İstanbul Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
¹⁶Department of Emergency Medicine, Akdeniz University, Faculty of Medicine, Antalya, Türkiye
¹⁷Department of Emergency Medicine, University of Health Sciences, Adana City Training and Research Hospital, Adana, Türkiye
¹⁸Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
¹⁹Department of Emergency Medicine, University of Health Sciences, Sultan 2.Abdülhamid Han Training and Research Hospital, İstanbul, Türkiye
²⁰Department of Emergency Medicine, Karadeniz Technical University, Faculty of Medicine, Trabzon, Türkiye
²¹Department of Emergency Medicine, Gazi University, Faculty of Medicine, Ankara, Türkiye
²²Department of Emergency Medicine, Erzurum City Hospital, Erzurum, Türkiye
²³Department of Emergency Medicine, İnönü University, Turgut Özal Medical Center, Malatya, Türkiye
²⁴Department of Emergency Medicine, Dicle University, Faculty of Medicine, Diyarbakır, Türkiye
²⁵Department of Emergency Medicine, Ankara University, Faculty of Medicine, Ankara, Türkiye
²⁶Department of Emergency Medicine, Ondokuz Mayis University, Faculty of Medicine, Samsun, Türkiye
²⁷Department of Emergency Medicine, Ege University, Faculty of Medicine, İzmir, Türkiye
²⁸Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, Ankara, Türkiye
²⁹Dr.Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Izmir, Türkiye
³⁰Department of Emergency Medicine, Manisa Merkezefendi State Hospital, Manisa, Türkiye
³¹Department of Emergency Medicine, Gaziantep University, Şahinbey Research and Practice Hospital, Gaziantep, Türk

Keywords: Bystander cardiopulmonary resuscitation, cardiopulmonary resuscitation, cardiopulmonary resuscitation, out-of-hospital cardiac arrest, registry, return of spontaneous circulation, survival, survived event, Turkey, Türkiye

Abstract

OBJECTIVES: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes.

MATERIALS AND METHODS: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes.

RESULTS: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge.

CONCLUSION: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

How to cite this article: Şener A, Pekdemir M, İslam MM, Aksay E, Karahan S, Aksel G, et al. Prospective, multicenter, Turkish out-of-hospital cardiac arrest study: TROHCA. Turk J Emerg Med 2024;24:133-44.