Out-of-hospital cardiac arrest: A review of major studies and a proposed uniform reporting system

The scientific literature from January 1970 to June 1979 was reviewed for articles reporting outcomes from out-of-hospital cardiac arrest treated by paramedic programs. Only articles appearing in refereed professional journals and reporting 25 or more attempted resuscitations were included. A total of 21 articles from 15 U.S. locations were found. Four separate case definitions were distinguished. Methods and reporting formats varied considerably. Few studies used an experimental or quasi-experimental design, or control or comparison groups. The range of attempted resuscitations varied from 26 to 1,106 patients. Patients admitted to hospital varied between 22% and 65% (mean 38%, S.D. ± 12.4%). Patients discharged alive varied from 3.5% to 31% (mean 17.2%, S.D. ± 7.1%). Post discharge survival was either not reported or reported in different formats. A simplified reporting format is proposed using factors known to be associated with successful resuscitation: 1) underlying heart disease etiology; 2) witnessed arrest; 3) cardiac rhythm of ventricular fibrillation/ventricular tachycardia; 4) hospital admission and discharge and, when possible, by time from collapse to initiation of cardiopulmonary resuscitation and definitive care. Uniform reporting of outcomes will improve comparability and accurate measurement of the impact of emergency programs on out-of-hospital cardiac arrest.