No improvement in surviving heart attack at home

WASHINGTON - Chances of surviving an out-of-hospital cardiac arrest have practically remained unchanged since the 1950s, according to a new report.

The analysis by University of Michigan Health System (UMHS) shows only 7.6 percent of victims survive an out-of-hospital cardiac arrest.

It’s a dismal trend considering enormous spending on heart research, new emergency care protocols, and the advent of new drugs and devices.

Each year, 166,000 people in the US experience cardiac arrest — an event during which the heart stops beating — away from a hospital.

“Our study shows that patients with a heart rhythm that can be shocked, or who have bystander CPR or a pulse restored at the scene have a much greater chance of survival,” says lead author of the study Comilla Sasson, an emergency medicine physician at the UMHS.

Although half of cardiac arrests are witnessed by a bystander, according to the study, only 32 percent, or about one in every three people, is receiving bystander cardiopulmonary resuscitation (CPR).

CPR is an emergency procedure to maintain flow of oxygenated blood to the brain and the heart, thereby delaying tissue death for successful resuscitation.

Researchers evaluated data on 142,740 patients from 79 studies published internationally between January 1950 and August 2008.

Of the more than 140,000 patients, only 23.8 percent survived to hospital admission, and 7.6 percent, or about one in 10 people, lived to be discharged from the hospital.

Cardiac arrest victims who received CPR from a bystander or a paramedic, and those who had a shockable heart rhythm, referred to as ventricular fibrillation, were more likely to survive.

The strongest predictor of survival was a return of spontaneous circulation, meaning a pulse was restored at the scene. Among them, 15.5 percent to 33.6 percent survived, says a UMHS release.

“Increasing bystander CPR rates, increasing the awareness and use of devices to shock the heart, and keeping paramedics on scene until they restore a person’s pulse needs to occur if we are ever going to change our dismal survival rate,” Sasson says.

While the overall rate of out-of-hospital cardiac arrest survival has not improved, the field of cardiac and cerebral resuscitation is rapidly evolving.