FROM COLLAPSE TO CARE: ANALYZING OUT-OF-HOSPITAL CARDIAC ARREST AND EMERGENCY RESUSCITATION OUTCOMES IN A TERTIARY HOSPITAL SETTING
Main Article Content
Keywords
Out-of-hospital cardiac arrest, OHCA, cardiac rhythm, ROSC, mortality, resuscitation, emergency medicine, Pakistan
Abstract
Background
Out-of-hospital cardiac arrest (OHCA) remains a significant public health issue globally. Survival outcomes depend heavily on both pre-hospital interventions and the quality of in-hospital resuscitation. This study aims to examine the clinical outcomes of OHCA cases presented to a private tertiary care hospital in Lahore, Pakistan, with a focus on the correlation between initial cardiac rhythm and resuscitation success.
Methods
A retrospective case series was performed by reviewing electronic medical records from August 2024 to January 2025. Patients were grouped based on their initial cardiac rhythm into two categories: shockable rhythms (ventricular fibrillation or pulseless ventricular tachycardia) and non-shockable rhythms (pulseless electrical activity or asystole). The main outcomes assessed were the achievement of Return of Spontaneous Circulation (ROSC) in the emergency department and subsequent mortality rates.
Results
Out of 45 initially reviewed cases, 7 were excluded due to being dead on arrival or having undergone prior resuscitation efforts. The remaining 38 patients were included in the final analysis. Among them, 80% of patients with shockable rhythms achieved ROSC, compared to 48.7% with non-shockable rhythms. Mortality was observed to be higher in the non-shockable group (51.3%) than in the shockable group (20.0%). A statistically significant association was found between initial rhythm type and ROSC outcome (χ² = 23.25, p < 0.001).
Conclusion
Initial cardiac rhythm plays a crucial role in predicting outcomes following OHCA. These results highlight the importance of early defibrillation, consistent emergency response protocols, and comprehensive training in resuscitation techniques. Improvements in emergency medical infrastructure and the establishment of nationwide resuscitation standards may enhance survival in resource-limited healthcare systems such as Pakistan’s.
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Dr Taarif Hussain, MD
Family & Emergency Medicine Department, Chair Emergency Services, IMC Hospital, Lahore, Pakistan
Dr Shahnila Ali
Public Health Professional, Primary & Urgent Health Care, Lahore, Pakistan
Dr Maaz Sohail Rana
Consultant Pulmonologist, Integrated Medical Care Hospital, DHA, Lahore, Pakistan
Dr Hasan Javed
Clinical Instructor - ER, IMC Hospital, Lahore, Pakistan
Dr Muhammad Abu Bakar
Clinical Instructor - ER, IMC Hospital, Lahore, Pakistan
Dr Hassan Naseem
Clinical Instructor - ER, IMC Hospital, Lahore, Pakistan