Morbidity and Mortality trend analysis of Out-of-Hospital Cardiac Arrest in Belgium, recorded in the B-CAR registry from 2017 to 2019.

Details

Supervisors

Penaloza Andrea ; Robert Annie

Faculty

Faculté de santé publique

Degree label

Master [120] en sciences de la santé publique, à finalité spécialisée

Abstract

Background: Out-of-Hospital Cardiac Arrest (OHCA) is a major public health problem leading to high morbidity and mortality rates. Early, effective and appropriate CardioPulmonary Resuscitation (CPR) is essential to improve OHCA outcomes. Improvement of OHCA survival rate requires analysis based on measurements of the four steps of “survival chain” to implement efficient public health actions. The aim of this study is to describe OHCA characteristics of the first two steps of “survival chain” and determine OHCA incidence, standardize mortality and lethality. Methods: Data were extracted from the Belgian OHCA registry (B-CAR) between January 1st, 2017 and December 31st, 2019. The statistics were performed on adult population (≥ 15 years) as OHCA remains rare in paediatric population (under 15, N=60). Demographic rates were performed for Brussels-Capital Region municipalities due to an under-representation of EMS in Flanders and in Wallonia. Results: In Brussels-Capital Region, OHCA incidence, standardize mortality, lethality rates were 34.26 person-year, 30.86 person-year and 90.1%, respectively. The OHCA incidence and standardize mortality rates increased with age in both sex group (p<0.05), displaying higher rates among males (IR 1.84 [1.57; 2.16). Spatial distribution disparities were observed between the south and the north of Brussels-Capital Region. The total OHCA survival rates were 40.22% [37.18; 43.26] at hospital admission, 24.04% [19.81; 28.28] at hospital discharge and 7.29% [2.09; 12.49] at 30 days follow-up (FU). A good physical and neurological recovery were reported during the 30 days FU by 6.22% [2.08; 12.23] of OHCA patients. Survival rates increased in the presence of a witness, especially when CPR was directly performed (60%) before EMS arrival (40.71%). The OHCA incidence rates increase with population densities and social determinants as low mean housing price/m² (p=0.016) and high birth rates (p=0.041). Conclusion: The OHCA incidence rates were as high as in others European countries and the survival rates at 30 days, with a good recovery, remained low. The involvement of all the Belgian EMS should be required for the forthcoming demographic and outcome analyses, avoiding the lack of recorded data, to reflect the Belgian OHCA reality and to strengthen public health policies and programmes improving the quality of OHCA care.