Patients who experience sudden cardiac arrest are more likely to die from the condition since the coronavirus pandemic began, a new study shows. According to research from the Smidt Heart Institute at Cedars-Sinai published in the August 2020 issue of JACC: Clinical Electrophysiology, individuals who had heart attacks outside of a hospital setting amid coronavirus are less likely to survive than they were before the pandemic.It’s not coronavirus itself that’s making heart attacks deadlier, however. The study’s authors found that there were two distinct factors that contributed to the uptick in cardiac-arrest-related mortality outside of a hospital setting: increased wait times for ambulances and reluctance on the part of bystanders to perform CPR.
The study’s findings are based on data from the Oregon Sudden Unexpected Death Survey, specifically comparing 278 incidences of out-of-hospital cardiac arrest that occurred from March 1 to May 31, 2020, to 231 that occurred within those same dates one year prior.Researchers found that, prior to the coronavirus pandemic, the average wait time for an ambulance following a heart attack was 6.6 minutes; amid the pandemic, that average was 7.6 minutes. In 2019, 61 percent of individuals who experienced an out-of-hospital heart attack received CPR from a bystander; by 2020, that number had dropped to just 51 percent. Surprisingly, among the potentially lifesaving measures that were performed less frequently amid the pandemic, it was bystander use of an automated external defibrillator (AED) that dropped the most year over year.While five percent of out-of-hospital cardiac arrests were treated using AEDs in 2019, by 2020, that number was just one percent. The combination of the reduction in bystander CPR and increased wait times for ambulances was associated with a significant drop in the likelihood patients would survive their hospitalization—14.7 percent of out-of-hospital cardiac arrest patients in the study were discharged from the hospital in 2019, but just 7.9 percent left the hospital alive in 2020.”When someone goes into cardiac arrest and collapses, they need to be resuscitated immediately,” said the study’s lead researcher Kyndaron Reinier, PhD, MPH, in a statement. “With each minute that goes by, the chance of survival goes down.”
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While some elements that led to the increased time it took for ambulances to reach patients—namely donning personal protective equipment—may be unavoidable, Reinier noted that changes to bystander intervention may save lives. While Reinier described bystander CPR as “critically important” to the survival of heart attack patients, she noted that it doesn’t have to include mouth-to-mouth, which could increase the risk of person-to-person coronavirus transmission. “For years, we have been recommending chest compressions only, so there is no need for face-to-face contact,” Reinier explained. And if you’re wondering what a resurgence of the virus could look like, This Is What Could Be Different About a Third COVID Wave.
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