Factors Associated With Survival of Out-Of-Hospital Cardiac Arrest by Emergency Medical Service at Surin Hospital
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Abstract
Background: Out-of-hospital cardiac arrest (OHCA) is a critical public health challenge and a leading cause of global mortality. Survival rates remain suboptimal and vary significantly based on local Emergency Medical Service (EMS) systems. Despite numerous studies in Thailand, localized data regarding factors and resuscitation outcomes specific to Surin Hospital remain limited. Such evidence is essential for refining clinical practice guidelines to enhance patient survival.
Objective: To identify factors associated with survival to hospital discharge including the return of spontaneous circulation (ROSC), survival to hospital admission, and neurological status, among OHCA patients transported by EMS to the Emergency Department of Surin Hospital.
Methods: This retrospective cohort study analyzed adult OHCA patients primarily transported by EMS to Surin Hospital between January 1st, 2021, and April 30th, 2025. Data were extracted from medical records and analyzed using multiple logistic regression to identify independent factors of survival outcomes.
Results: A total of 292 patients were included in the study. Factors significantly associated with survival to hospital discharge included arrest in non-residential areas (aOR = 5.48, 95% CI: 1.34–22.32), prehospital administration of amiodarone (aOR = 35.56, 95% CI: 3.61–350.34), and the presence of a palpable pulse upon arrival at the emergency department (aOR = 99.22, 95% CI: 8.59–1146.12). Overall, 13 patients (4.5%) survived to hospital discharge, and 14 patients (4.8%) achieved favorable neurological outcomes.
Conclusions: Survival in the context of Surin Hospital is strongly correlated with prehospital interventions, particularly rapid resuscitation leading to ROSC prior to or upon arrival. Improving EMS efficiency and increasing bystander CPR rates are critical strategies for improving the survival of OHCA patients.
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