Enhancing Survival Rates in Cardiac Arrest: Study Benchmarks Insights from Cardiac Arrest Registry

Cardiac arrest registries are critical tools for benchmarking quality of care and improving outcomes in resuscitation science by catering to the diverse perspectives of key stakeholders, including Emergency Medical Communication Centres (EMCC), Emergency Medical Services (EMS), In-Hospital Care Providers (IHCP), and Recovery and Rehabilitation Providers (RRP). Recently published study evaluated the Norwegian Cardiac Arrest Registry (NorCAR) provides extensive data relevant for these categories, with a 2022 descriptive statistical analysis illustrating the complexities involved in cohort selection.

Incidence of Cardiac Arrest

The total incidence of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) in Norway stands at 100 per 100,000 inhabitants. Specific cohorts were curated for each stakeholder group to address variances in treatment and improvement opportunities. For instance, EMCC was focused on unconscious patients not breathing normally at the time of call, while EMS included confirmed cardiac arrests treated by paramedics. Findings indicated that EMCC initiated treatment for 3,591 patients (incidence rate of 67 per 100,000), achieving a bystander CPR rate of 83%. EMS attended to 4,150 patients (incidence of 77 per 100,000), with notable rates for EMS-initiated CPR at 57% and bystander rates at 65%. The cohort for IHCP included 1,114 patients admitted alive to the hospital or with ongoing CPR, out of which survival to 30 days was measured at 8.3 per 100,000. For rehabilitation purposes, the follow-up cohort identified 1,227 patients who survived 24 hours post-arrest, out of which 705 were from OHCA and 522 from IHCA, providing vital data not only focused on immediate survival but also long-term functional outcomes and quality of life. Such stratification highlights the importance of tailored approaches as different cohorts yield varying outcomes, emphasizing the necessity for precise definitions and reporting mechanisms aligned with stakeholder interests.

Importance of Cohort Definitions in Quality Improvement

Significantly, the study emphasizes that in order for registry outputs to contribute to meaningful quality improvement projects, precise cohort definitions tailored per stakeholder needs are essential. This understanding allows for better benchmarking against international standards and facilitates improvements across all facets of the treatment chain, ultimately enhancing public health responses and resource allocation in cardiac arrest management. The study concludes that clarity in cohort definitions is paramount for advancing effective quality improvement initiatives and research in resuscitation science, thereby directly affecting patient care evolution.

Key Points

- -Role of Cardiac Arrest Registries-: Cardiac arrest registries serve as essential tools for enhancing care quality and improving outcomes in resuscitation science by addressing the multifaceted perspectives of stakeholders, which include Emergency Medical Communication Centres (EMCC), Emergency Medical Services (EMS), In-Hospital Care Providers (IHCP), and Recovery and Rehabilitation Providers (RRP).

- -Incidence Rates and Cohort Specificity-: The overall incidence of cardiac arrest in Norway is reported at 100 per 100,000 inhabitants, with distinct cohorts established for different stakeholders. EMCC specifically focuses on patients who are unconscious and not breathing normally, while EMS involves confirmed cases treated by paramedics, yielding incidence rates of 67 per 100,000 for EMCC and 77 per 100,000 for EMS.

- -Survival Statistics and Resuscitation Outcomes-: From a cohort of 1,114 patients admitted to hospitals, survival rates to 30 days were measured at 8.3 per 100,000. Rehabilitation cohorts revealed that among 1,227 patients who survived beyond 24 hours post-arrest, a breakdown showed 705 were OHCA and 522 were IHCA patients, emphasizing the need for tracking both immediate survival and longer-term outcomes.

- -Significance of Bystander and EMS-Initiated CPR Rates-: Bystander CPR rates achieved by EMCC were 83%, while EMS-initiated CPR rates were notable at 57% with a bystander rate of 65%. These CPR rates underline the critical role of immediate response in improving survival outcomes and the effectiveness of public awareness and training initiatives.

- -Cohort Definitions for Quality Improvement-: The necessity for precise cohort definitions tailored to the needs of various stakeholders is stressed as fundamental for effective quality improvement projects. Clear definitions facilitate benchmarking against international standards and highlight improvement opportunities throughout the treatment continuum.

- -Impact on Public Health and Resource Allocation-: The clarity in cohort definitions supports advancements in quality improvement initiatives and research in resuscitation science, with direct implications for patient care evolution and enhancements in public health responses and resource allocation strategies in managing cardiac arrests.

Reference –

I. Tjelmeland et al. (2025). Patient Cohorts Of Interest In Resuscitation Science - Aligning Cardiac Arrest Registry Outputs With Stakeholder Needs.. *Resuscitation*, 110509 . https://doi.org/10.1016/j.resuscitation.2025.110509.