Prognosis of Out-of-Hospital Cardiac Arrest in Underserved Rural Area

Background: Epidemiological data are lacking on patients in the rural areas who are being admitted after out-of-hospital cardiac arrest (OHCA). We report here the first descriptive analysis study of patients who were hospitalized and treated after OHCA at an academic medical center in the Lower Galilee which located in the north part of Israel. Methods: This is a descriptive, retrospective analysis of all patients admitted after OHCA to Tzafon Medical Center between the years 2017 and 2023. The analysis consists of the epidemiological, social, and clinical data based on the electronic medical records. Results: A total of 62 patients were included in this analysis, 82% were men with a median age of 61.5 years old. Thirty-four percent had history of ischemic heart disease (IHD) and 60% history of hypertension. Twenty-seven (44%) patients died during their admission. In 49 (79%) patients the first rhythm on emergency medical service (EMS) arrival was a shockable rhythm and 30 (48%) patients had a ST-elevation myocardial infarction (STEMI) on electrocardiogram (ECG). Patients who were admitted to the hospital after OHCA were more likely to be discharged alive if they had no history of IHD (n = 27; p = 0.037), hypertension, or hyperlipidemia. Moreover, the presence of first shockable rhythm on the first ECG that performed by EMS was associated with higher rates of survival (n = 33; p < 0.001). Conclusions: We present the first single-center epidemiological analysis of patients admitted after OHCA at a rural area in Israel, with an in-hospital survival rate of 56%. Patients without history of IHD, hypertension, hyperlipidemia, and acute kidney injury and those with first shockable rhythm were more likely to discharged alive.