PP23?Linking pre-hospital out-of-hospital cardiac arrest data to in-hospital outcomes in order to improve the ‘chain of survival’

摘要

A first step to improving outcomes after Out-of-hospital cardiac arrest is to measure the performance of the local ‘Chain of Survival’. Ambulance services routinely report the number of OHCA where resuscitation is attempted, but lack access to outcome data such as survival to hospital discharge. Our novel data linkage project has been developed to inform the implementation of UK’s strategy for OHCA and provide insight into both short- and long-term patient outcomes.Scottish Ambulance Service data was used to identify OHCA incidents where resuscitation was attempted between 2011–2015. OHCA incidents were then probabilistically matched to a range of administrative datasets based on Community Health Index (CHI) linkage. The data were stored and accessed through a Safe Haven where it was used to determine baseline characteristics of the ‘Chain of Survival’ in UK.Around 3,000 OHCA cases per year were identified with around 6.2% survival to hospital discharge. Of all cases 73.2% could be linked with other datasets such as hospital data (SMR01 and intensive care data), deaths data and SPARRA (comorbidities). This resulted in a rich dataset including a range of demographics, survival and clinical performance measures. Logistic regression models showed that a higher age, male gender and living in a socially deprived area are associated with a higher risk of an OHCA. Higher age and living in a rural or socially deprived area are also associated with an increased mortality risk.Our data set the scene for the implementation of UK’s Strategy for OHCA providing insight into the performance of whole ‘Chain of Survival’. It offers the opportunity to identify priority areas for improvement and track impact of strategy implementation.