Out-of-hospital cardiac arrest in high-rise buildings: delays to patient care and effect on survival

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Figure 1:
CONSORT diagram for flow of patients in a study of out-of-hospital cardiac arrest in private residences.

Table 1:

Demographic and clinical characteristics of patients with cardiac arrest occurring in a private residence, by floor of patient contact

Characteristic	Floor of contact; no. (%) of patients^*		p value
Characteristic	< Floor 3 n = 5998	≥ Floor 3 n = 1844	p value
Age, yr, mean ± SD	70.6 ± 15.9	70.8 ± 15.6	0.8
Sex, male	3773/5998 (62.9)	1077/1844 (58.4)	< 0.001
Event witnessed by bystander	2504/5954 (42.1)	727/1832 (39.7)	0.07
Bystander performed CPR	2102/5998 (35.0)	671/1844 (36.4)	0.3
Time from 911 call response to arrival on scene, min, mean ± SD	6.2 ± 2.3	6.2 ± 2.2	0.9
Initial shockable rhythm present	1136/5976 (19.0)	243/1827 (13.3)	< 0.001
Time from arrival of 911 responder^† to patient contact, min, mean ± SD	3.0 ± 2.0	4.9 ± 2.6	0.01
Return of spontaneous circulation	1738/5998 (29.0)	478/1844 (25.9)	0.01
AED application before arrival of 911 responder^†	19 (0.3)	7 (0.4)	0.8

Note: AED = automated external defibrillator, CPR = cardiopulmonary resuscitation, SD = standard deviation.
↵* Except where indicated otherwise.
↵† 911-initiated first responders include both paramedics and fire department personnel.

Table 2:

Unadjusted and adjusted analyses of variables associated with patient survival to hospital discharge

Variable	No. (%) of patients^*^†		OR (95% CI)

	Survived n = 300	Did not survive n = 7538	Unadjusted	Adjusted^‡
Age, yr, mean ± SD	60.1 ± 16.3	71.1 ± 15.7	0.96 (0.958–0.97)	0.96 (0.95–0.97)

Sex, male	201/300 (67.0)	4647/7538 (61.6)	0.77 (0.61–0.98)	0.72 (0.54–0.95)

Event witnessed by bystander	224/294 (76.2)	3007/7488 (40.2)	4.76 (3.68–6.25)	2.93 (2.16–3.98)

Contact at or above floor 3	48/300 (16.0)	1795/7538 (23.8)	0.61 (0.44–0.83)	0.70 (0.50–0.99)

Bystander performed CPR	136/300 (45.3)	2637/7538 (35.0)	1.55 (1.23–1.94)	1.07 (0.83–1.39)

911 response time, min, mean ± SD	5.8 ± 2.1	6.2 ± 2.3	0.89 (0.83–0.95)	0.86 (0.79–0.92)

Initial shockable rhythm present	219/297 (73.7)	1160/7502 (15.5)	14.65 (11.39–19.02)	10.68 (7.98–14.29)

Time from arrival of 911 responder to patient contact, min, mean ± SD	3.2 ± 1.9	3.5 ± 2.2	0.93 (0.88–0.98)	NA

Note: CI = confidence interval, CPR = cardiopulmonary resuscitation, NA = not applicable, OR = odds ratio, SD = standard deviation.
↵* Except where indicated otherwise.
↵† Four patients were excluded because of missing outcome data.
↵‡ Adjusted for age, sex, witness status, bystander CPR, 911 response time, initial cardiac rhythm and floor of contact (< 3 v. ≥ 3).

Table 3:

Unadjusted and adjusted analyses of variables associated with return of spontaneous circulation (ROSC)

Variable	No. (%) of patients^*		OR (95% CI)

	ROSC n = 2216	No ROSC n = 5626	Unadjusted	Adjusted^†
Age, yr, mean ± SD	71.0 ± 15.4	70.6 ± 16.0	1.00 (0.99–1.00)	1.00 (1.00–1.01)

Sex, male	1325/2216 (59.8)	3525/5626 (62.7)	0.89 (0.80–0.98)	0.74 (0.67–0.83)

Event witnessed by bystander	1310/2194 (59.7)	1921/5592 (34.4)	2.83 (2.56–3.14)	2.47 (2.22–2.75)

Contact at or above floor 3	478/2216 (21.6)	1366/5626 (24.3)	0.86 (0.76–0.96)	0.90 (0.79–1.02)

Bystander performed CPR	889/2216 (40.1)	1884/5626 (33.5)	1.33 (1.20–1.47)	1.16 (1.04–1.29)

911 response time, min, mean ± SD	6.1 ± 2.3	6.2 ± 2.3	0.99 (0.97–1.01)	0.98 (0.95–1.00)

Initial shockable rhythm present	668/2212 (30.2)	711/5591 (12.7)	2.97 (2.63–3.35)	2.39 (2.10–2.72)

Time from arrival of 911 responder to patient contact, min, mean ± SD	3.3 ± 2.3	3.5 ± 2.3	0.97 (0.95–0.99)	NA

Note: CI = confidence interval, CPR = cardiopulmonary resuscitation, NA = not applicable, OR = odds ratio, SD = standard deviation.
↵* Except where indicated otherwise.
↵† Adjusted for age, sex, witness status, bystander CPR, 911 response time, initial cardiac rhythm and floor of contact (< 3 v. ≥ 3).