Predictors of Mortality in Out-of-hospital Cardiac Arrest (OHCA) Patients: A Retrospective Cross-sectional Study from the Sultanate of Oman.

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) is a significant global health challenge with high incidence and low survival rates; this study aimed to predict mortality in these patients.

Methods: This 5-year retrospective chart review, conducted at the emergency departments (EDs) of two tertiary hospitals, systematically categorized, coded, and analyzed variables to assess mortality risk in OHCA patients.

Results: Of the 822 (36.5%) patients who met the inclusion criteria, the mean age was 60.2 years (SD ± 17.6), with 65.7% being male. Cardiopulmonary resuscitation (CPR) was attempted on 586 patients, with 178 (30.4%) achieving return of spontaneous circulation (ROSC) in the ED. Significant risk factors for mortality included hypertension (p = 0.01), diabetes mellitus (p = 0.05), respiratory illnesses (p = 0.04), and having three or more comorbidities (p = 0.01). Manifestations in previous ED visits (<180 days), such as cardiac complaints (p = 0.05) and dyspnea due to fluid overload (p = 0.02), were significant. Among the cohort, 76.4% visited the ED (<180 days) and had a mortality rate of 95.7%, compared to 78.4% for those who did not visit. Asystole and pulseless electrical activity (PEA) were significant factors for the nonachievement of ROSC (p < 0.001 vs p = 0.032) and mortality (p < 0.001 vs p = 0.03). Overall, 49 patients (8.4%) survived to hospital discharge.

Conclusion: Elderly males with hypertension, diabetes, respiratory ailments, and multiple comorbidities constituted a significant risk group. Factors such as prior episodes of chest pain and fluid overload were associated with higher mortality. Patients with asystole and PEA had low survival rates.

How to cite this article: Al-Habsi T, Al-Mandhari A, Hazra D, Al-Badri M, Al Harthi K, Al-Obaidani T, et al. Predictors of Mortality in Out-of-hospital Cardiac Arrest (OHCA) Patients: A Retrospective Cross-sectional Study from the Sultanate of Oman. Indian J Crit Care Med 2024;28(11):1056-1062.