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Rates of survival from out-of-hospital cardiac arrest (OHCA) have been notoriously poor (NEJM JW Gen Med Apr 16 1999). However, the past decade has seen a shift in resuscitative strategies, with increased emphasis on high-quality cardiopulmonary resuscitation, early defibrillation, and prevention of hyperthermia. Two large cohort studies, one from the U.S. (Cardiac Arrest Registry to Enhance Survival [CARES]) and one from Canada analyzed trends in OHCA survival.
The CARES registry included data for more than 70,000 OHCA patients treated between 2005 and 2012. Adjusted rates of survival to hospital discharge improved significantly, from 5.7% to 8.3%, with an associated improvement in neurological outcomes for survivors. The increase was seen …