Prospective, multicenter, Turkish out-of-hospital cardiac arrest study: TROHCA
Authors: Şener Alp , Pekdemir Murat , İslam Mehmet Muzaffer , Aksay Ersin , Karahan Sevilay , Aksel Gokhan , Doğan Nurettin Özgür , Öztürk Berkant , Hacımustafaoğlu Muhammet , Türkücü Çağrı , Eroğlu Serkan Emre , Yürümez Yusuf , Aslan Nuray , Güner Necip Gokhan , User Neşe Nur , Aldemir Hüseyin , Girişgin Abdullah Sadik , Koçak Sedat , Ataman Sami , Özhasenekler Ayhan , Günaydın Gul Pamukçu , Sayhan Mustafa Burak , Salt Ömer , Bozatlı Satuk Bugra Han , Arslan Engin Deniz , Yılmaz Fevzi , Sivil Ramazan , Köksal Özlem , Durak Vahide Aslıhan , Özdemir Fatma , Taş Mahmut , Karakoç Yenal , Avınca Öner , Arık Yunus Emre , Melekoğlu Adem , Çevrim Özgür , Yiğit Özlem , Oktay Cem , İbze Süleyman , Satar Salim , Gülen Muge , Acehan Selen , Altunbaş Erhan , Saçak Melis Efeoğlu , Ünal Emir , Çevik Erdem , Satılmış Dilay , Asan Hande , Karaca Yunus , İmamoğlu Melih , Özer Vildan , Demircan Ahmet , Keleş Ayfer , Kadı Gültekin , Delice Orhan , Utlu Sibel Güçlü , Arslan Senol , Yücel Neslihan , Gürbüz Şükrü , Ayhan Hüseyin Burak , Şen Abdullah , Yaman Mahmut , Günalp Müge , Genç Sinan , Baydın Ahmet , Çalışkan Fatih , Temür Şeyma Arzu , Ersel Murat , Yalçınlı Sercan , Özçete Enver , Erbil Bulent , Ince Elif Ozturk , Karaca Mehmet Ali , Çetin Murat , Demirbağ Mehmet , Sabak Mustafa , Bozkurt Mustafa 
Published: July 2024

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.