Outcomes of Out-of-Hospital Cardiac Arrest with Initial Shockable Rhythm: The Role of Bystander and Dispatch-Guided CPR in Sarajevo's Physician-Led Emergency Medical Teams
Background: The Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge worldwide, with survival outcomes heavily influenced by early intervention. The presence of an initial shockable rhythm significantly increases the likelihood of survival when combined with timely cardiopulmonary resuscitation (CPR) and defibrillation. Objective: To analyze patient outcomes and the incidence of bystander and dispatch-guided CPR in cases of OHCA with an initial shockable rhythm treated by physician-led emergency medical teams in Bosnia and Herzegovina. Methods: Data for this study were collected over a 5-year period, from January 2019 to September 2023, using the Utstein protocol. Hospital records were analyzed to determine patient outcomes, with a focus on the 30-day survival rate and favorable neurological outcomes. Instances of dispatch-guided and bystander CPR were recorded for each case based on available patient records. Results: In this study, 1,020 patients were included, with 151 cases (14.8%) having an initial shockable rhythm, of which 14.3% of males and 4.4% of females achieved return of spontaneous circulation (ROSC). ROSC rates varied by year, with the highest in 2019 (20.4%) and 2022 (17.9%). Thirty-day survival with a good neurological outcome was observed in a small percentage of cases. The initial shockable rhythm was found to be statistically significant (p
Key words: CPR; OHCA; ROSC; epidemiology; Bosnia and Herzegovina.
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