The Influence of the COVID-19 Pandemic on Emergency Medical Services to Out-of-Hospital Cardiac Arrests in a Low-Incidence Urban City: An Observational Epidemiological Analysis

Chung-Hsien Liu, Ming-Jen Tsai, Chi-Feng Hsu, Cheng-Han Tsai, Yao-Sing Su and Deng-Chuan Cai ()
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Chung-Hsien Liu: Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan
Ming-Jen Tsai: Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan
Chi-Feng Hsu: Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan
Cheng-Han Tsai: Department of Emergency Medicine, Taichung Veteran’s General Hospital, Chia-Yi Branch, Chiayi City 600, Taiwan
Yao-Sing Su: Fire Bureau, Chiayi City Government, Chiayi City 600, Taiwan
Deng-Chuan Cai: Graduate School of Design, National Yunlin University of Science and Technology, Yunlin 640, Taiwan

IJERPH, 2023, vol. 20, issue 3, 1-12

Abstract: The Emergency Medical Services (EMS) system faced overwhelming challenges during the coronavirus disease 2019 (COVID-19) pandemic. However, further information is required to determine how the pandemic affected the EMS response and the clinical outcomes of out-of-hospital cardiac arrest (OHCA) patients in COVID-19 low-incidence cities. A retrospective study was conducted in Chiayi, Taiwan, a COVID-19 low-incidence urban city. We compared the outcomes and rescue records before (2018–2019) and during (2020–2021) the COVID-19 pandemic. A total of 567 patients before and 497 during the pandemic were enrolled. Multivariate analysis revealed that the COVID-19 pandemic had no significant influence on the achievement of return of spontaneous circulation (ROSC) and sustained ROSC but was associated with lower probabilities of survival to discharge (aOR = 0.43, 95% CI: 0.21–0.89, p = 0.002) and discharge with favorable neurologic outcome among OHCA patients (aOR = 0.35, 95% CI: 0.16–0.77, p = 0.009). Patients’ ages and OHCA locations were also discovered to be independently related to survival results. The overall impact of longer EMS rescue times on survival outcomes during the pandemic was not significant, with an exception of the specific group that experienced prolonged rescue times (total EMS time > 21 min).

Keywords: emergency medical service; COVID-19 pandemic; out-of-hospital cardiac arrest (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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