Effect of reducing ambulance response times on deaths from out of hospital cardiac arrest: cohort study

Pell, J.P. , Sirel, J.M., Marsden, A.K., Ford, I. and Cobbe, S.M. (2001) Effect of reducing ambulance response times on deaths from out of hospital cardiac arrest: cohort study. British Medical Journal, 322, pp. 1385-1388. (doi: 10.1136/bmj.322.7299.1385)

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Publisher's URL: http://dx.doi.org/10.1136/bmj.322.7299.1385

Abstract

OBJECTIVES: To determine the association between ambulance response time and survival from out of hospital cardiopulmonary arrest and to estimate the effect of reducing response times. DESIGN: Cohort study. SETTING: Scottish Ambulance Service. Subjects: All out of hospital cardiopulmonary arrests due to cardiac disease attended by the Scottish Ambulance Service during May 1991 to March 1998. MAIN OUTCOME MEASURES: Survival rate to hospital discharge and potential improvement from reducing response times. RESULTS: Of 13 822 arrests not witnessed by ambulance crews but attended by them within 15 minutes, complete data were available for 10 554 (76%). Of these patients, 653 (6%) survived to hospital discharge. After other significant covariates were adjusted for, shorter response time was significantly associated with increased probability of receiving defibrillation and survival to discharge among those defibrillated. Reducing the 90th centile for response time to 8 minutes increased the predicted survival to 8%, and reducing it to 5 minutes increased survival to 10-11% (depending on the model used). CONCLUSIONS: Reducing ambulance response times to 5 minutes could almost double the survival rate for cardiac arrests not witnessed by ambulance crews.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pell, Professor Jill and Cobbe, Professor Stuart and Ford, Professor Ian
Authors: Pell, J.P., Sirel, J.M., Marsden, A.K., Ford, I., and Cobbe, S.M.
Subjects:R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
College of Medical Veterinary and Life Sciences
College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:British Medical Journal
Journal Abbr.:BMJ
Publisher:BMJ Publishing Group
ISSN:0959-535X
ISSN (Online):1756-1833
Copyright Holders:© BMJ Publishing Group
First Published:First published in the BMJ 322:1385-1388
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher.

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