American Journal of Epidemiology Vol. 134, No. 8: 851-861
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
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Change in Survival from Out-of-Hospital Cardiac Arrest and Its Effect on Coronary Heart Disease Mortality, Minneapolis-St. Paul
The Minnesota Heart Survey
1Department of Medicine, Kaiser Permanente Medical Center Sacramento, CA
2Division of Epidemiology, School of Public Health, University of Minnesota Minneapolis, MN
3Department of Epidemiology and Biostatistics, Mayo Clinic Rochester, MN
4Department of Epidemiology and Public Health, School of Medicine, University of Miami Miami, FL
5Department of Family Practice and Community Health, School of Medicine, University of Minnesota Minneapolis, MN
6Department of internal Medicine, School of Medicine, University of Minnesota Minneapolis, MN
Reprint requests to Dr. Katherine M Doliszny, 210 Moos Tower, Division of Epidemiology, School of Public Health, University of Minnesota, 515 Delaware Street SE, Minneapolis, MN 55455
Emergency medical services with advanced life support systems were implemented in the Minneapolis-St. Paul, Minnesota, area in the mid-1970s. To assess the impact of emergency medical services on coronary heart disease mortality, the authors reviewed ambulance records and hospital emergency room logs for possible out-of-hospital cardiac arrest cases in the period 1972–1982. Potential cases, and their survival to discharge, were validated by hospital record review and were checked against Minnesota death certificates for the year of cardiac arrest and the year following cardiac arrest. Age-adjusted rates of survival to 1 year after cardiac arrest (per 100, 000 population) for survivors of out-of-hospital cardiac arrest aged 30–74 years increased significantly from 1972 to 1982 for men (1.8 vs. 11.7; p < 0.00001) and for women (0.5 vs. 3.5; p < 0.01). Coronary heart disease mortality rates declined in that period by 34 9% for men (from 527.5 per 100, 000 to 343.3 per 100, 000) and by 41.7% for women (from 168.6 per 100,000 to 98.3 per 100,000). The authors estimate that improved survival from out-of-hospital cardiac arrest contributed 5.4% (9.9 of 184.2) of the mortality decline for men and 4.3% (3.0 of 70.3) of the decline for women. This was a significant contribution to the decline in coronary heart disease mortality, but it explains only a small part of it.
coronary disease; emergency medical services; heart arrest; survival
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