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Sudden cardiac death (SCD) is a significant issue affecting national health policies. TheNational Emergency Department Information System for Cardiac Arrest (NEDIS-CA)consortium managed a prospective registry of out-of-hospital cardiac arrest (OHCA) at theemergency department (ED) level. We analyzed the NEDIS-CA data from 29 participatinghospitals from January 2008 to July 2009. The primary outcomes were incidence of OHCAand final survival outcomes at discharge. Factors influencing survival outcomes wereassessed as secondary outcomes. The implementation of advanced emergencymanagement (drugs, endotracheal intubation) and post-cardiac arrest care (therapeutichypothermia, coronary intervention) was also investigated. A total of 4,156 resuscitationattemptedOHCAs were included, of which 401 (9.6%) patients survived to discharge and79 (1.9%) were discharged with good neurologic outcomes. During the study period, therewere 1,662,470 ED visits in participant hospitals; therefore, the estimated number ofresuscitation-attempted CAs was 1 per 400 ED visits (0.25%). Factors improving survivaloutcomes included younger age, witnessed collapse, onset in a public place, a shockablerhythm in the pre-hospital setting, and applied advanced resuscitation care. We foundthat active advanced multidisciplinary resuscitation efforts influenced improvement in thesurvival rate. Resuscitation by public witnesses improved the short-term outcomes (returnof spontaneous circulation, survival admission) but did not increase the survival todischarge rate. Strategies are required to reinforce the chain of survival and high-qualitycardiopulmonary resuscitation in Korea.

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