About 60 000 people have an out-of-hospital cardiac arrest (OHCA) in the UK each year.1 Frustratingly, despite major advances in medical technology only around 8% of patients admitted to hospital survive to discharge;2 furthermore, around a half of survivors have significant cognitive impairment.34 Identifying which patients are likely to survive and then which survivors are most likely to enjoy a reasonable quality of life is a major clinical challenge, particularly when attempting to make an assessment in the emotionally charged circumstances of an emergency admission.
OHCA encompasses a broad spectrum. Most patients have an unwitnessed arrest without early bystander cardiopulmonary resuscitation (CPR) and an initial non-shockable rhythm (pulseless electrical activity or asystole). The outcome in this group is very poor, with <2% surviving to discharge, and only 0.6% having a good neurological outcome.5 Better outcomes are seen in patients with a...
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