Abstract
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a prominent medical concern worldwide. Epidemiologic metrics and trends over time for OHCA cases in Canada are not well defined. This study evaluated geographic differences in the incidence and outcomes of OHCA patients admitted to hospitals across Canada, during the period 2013-2017. METHODS: This population-based retrospective cohort study included 10,492 nontraumatic OHCA patients aged 2-85 years (66% male) who were admitted to an acute-care hospital in any Canadian province or territory (excluding Quebec) between 2013 and 2017. Overall age- and sex-standardized incidence measures (per 100,000 population per year) were calculated through direct standardization to the 2016 Canadian population. Temporal trends in incidence and survival to hospital discharge were evaluated. RESULTS: The overall age- and sex-standardized incidence of OHCA patients admitted to the hospital was 8.3 per 100,000 population per year, which did not change significantly from 2013 to 2017 (incidence rate ratio: 1.01, 95% confidence interval: 0.99-1.02). The incidence was highest in British Columbia (9.2 per 100,000 population per year), Manitoba (9.0 per 100,000 population per year), and Nova Scotia (9.0 per 100,000 population per year), and lowest in New Brunswick (6.5 per 100,000 population per year), Prince Edward Island (6.8 per 100,000 population per year), and Saskatchewan (7.5 per 100,000 population per year). The proportion of OHCA patients who survived to hospital discharge was highest in Prince Edward Island (57%) and lowest in Ontario (38%). No significant trend in rates of survival to hospital discharge was observed from 2013 (43%) to 2017 (42%; P = 0.86). CONCLUSIONS: The age- and sex-standardized incidence of OHCA patients admitted to the hospital, and their survival outcomes, were stable in Canada from 2013 to 2017, with considerable variation noted across geographic regions.