Cardiac Arrest Survival Information
The "gold standard" for reporting community cardiac arrest survival is the percentage of patients discharged alive following out-of-hospital witnessed ventricular fibrillation. Witnessed refers to a collapse that is seen or heard. Ventricular fibrillation (VF) is defined as the first obtained rhythm after the collapse, as interpreted either by a human (such as a paramedic using a manual defibrillator) or an EMT using an automated external defibrillator (AED) that automatically identifies VF when it is present. Discharge alive is defined as discharge from an acute care hospital either to home, nursing home, extended care facility, or rehabilitation hospital.
Though discharged alive is the most commonly used outcome, many communities are also attempting to determine the neurological status of the patient upon discharge or one-month following discharge. Neurological status is measured using a 4-point cerebral performance category (CPC). A CPC score of 1 (conscious, alert, able to work, mild neurological or psychological deficit) or 2 (conscious, sufficient neurological function for independent activities of daily life) are often lumped together and are considered good outcomes. A score of 3 indicates inability to perform independent activities of daily life and a score of 4 indicates comatose or vegetative state. Clearly scores of 3 or 4 indicate poor neurological outcomes. The scores do not take into account a patient's neurological status before the cardiac arrest. In general, it is challenging to determine CPC scores and such measurements are usually confined to research studies or to communities with extensive, ongoing cardiac arrest surveillance programs. In King County we determine the CPC score from a review of the patient's hospital discharge record.