Survival and neurological outcomes among OHCA patients in middle- and high-income countries in the Asia-Pacific.
Journal
Resuscitation
Journal Volume
211
ISSN
1873-1570
Date Issued
2025-06
Author(s)
Fang, Kexin
Fook-Chong, Stephanie
Okada, Yohei
Siddiqui, Fahad Javaid
Shahidah, Nur
Tanaka, Hideharu
Shin, Sang Do
Kajino, Kentaro
Lin, Chih-Hao
Kuo, Chan-Wei
Karim, Sarah
Jirapong, Supasaowapak
Chen, Christina
Ong, Marcus Eng Hock
Abstract
Background: Currently, there is a knowledge gap on how OHCA impacts lower-resourced areas, and how they fare compared to their higher-resourced counterparts. This study aims to explore the relationship between a country's income category and neurological outcomes after OHCA in the Asia-Pacific region. Methods: A multivariable logistic regression model was applied to the prospective Pan-Asian Resuscitation Outcomes Study (PAROS) dataset. The main exposure was country income status (defined by the World Bank), and the main outcome was neurological outcomes (measured by cerebral performance category score). Sensitivity analyses were run to evaluate the robustness of our findings. Results: Out of a total of 207,450 PAROS cases between 2009–2018, 168,967 OHCA cases were included in the study. 165,404 cases were from high-income countries and 3,563 cases were from middle-income countries. All pediatric, pronounced dead at scene, unknown on-scene survival status, no resuscitation attempted, and traumatic cases were excluded from the analysis. A larger proportion of OHCA patients in high-income countries survived with favorable neurological outcomes (3.65%) compared to middle-income countries (0.75%). High-income countries were associated with better neurological outcomes (AOR 9.05; 95% CI 6.27 to 13.72). Results remained consistent throughout sensitivity analyses. Conclusion: In the PAROS cohort, high-income countries outperform middle income countries in post-OHCA neurological outcomes. Further research is needed to obtain better quality data in middle-income countries and expand reach into low-income countries.
Subjects
Economic Factors
Low- and Middle-Income Countries
Neurological outcome
Out-of-Hospital Cardiac Arrest
SDGs
Publisher
Elsevier Ireland Ltd
Description
Article Number：110592
Type
journal article