The comparison of emergency medical service responses to and outcomes of out‐of‐hospital cardiac arrest before and during the COVID‐19 pandemic in Thailand: a cross‐sectional study

The comparison of emergency medical service responses to and outcomes of out‐of‐hospital cardiac arrest before and during the COVID‐19 pandemic in Thailand: a cross‐sectional study

COVID-19, Emergency medical services, Out-of-hospital cardiac arrest, Response time, ROSC

Background During the coronavirus disease 2019 (COVID-19) pandemic, the format of patients with out-of-hospital
cardiac arrest (OHCA) management was modified. Therefore, this study compared the response time and survival at
the scene of patients with OHCA managed by emergency medical services (EMS) before and during the COVID-19
pandemic in Thailand.
Methods This retrospective, observational study used EMS patient care reports to collect data on adult patients with
OHCA coded with cardiac arrest. Before and during the COVID-19 pandemic was defined as the periods of January 1,
2018–December 31, 2019, and January 1, 2020–December 31, 2021, respectively.

Results A total of 513 and 482 patients were treated for OHCA before and during the COVID-19 pandemic, respec-
tively, showing a decrease of 6% (% change difference =− 6.0, 95% confidence interval [CI] − 4.1, − 8.5). However,

the average number of patients treated per week did not differ (4.83 ± 2.49 vs. 4.65 ± 2.06; p value = 0.700). While
the mean response times did not significantly differ (11.87 ± 6.31 vs. 12.21 ± 6.50 min; p value = 0.400), the mean
on-scene and hospital arrival times were significantly higher during the COVID-19 pandemic compared with before

by 6.32 min (95% CI 4.36–8.27; p value < 0.001), and 6.88 min (95% CI 4.55–9.22; p value < 0.001), respectively. Multi-
variable analysis revealed that patients with OHCA had a 2.27 times higher rate of return of spontaneous circulation

(ROSC) (adjusted odds ratio = 2.27, 95% CI 1.50–3.42, p value < 0.001), and a 0.84 times lower mortality rate (adjusted
odds ratio = 0.84, 95% CI: 0.58–1.22, p value = 0.362) during the COVID-19 pandemic period compared with that
before the pandemic.
Conclusions In the present study, there was no significant difference between the response time of patients with
OHCA managed by EMS before and during COVID-19 pandemic period; however, markedly longer on-scene and

Thongpitak Huabbangyang1

, Rossakorn Klaiangthong1*, Agasak Silakoon1

, Suttida Sretimongkol2
,

Sutasinee Sangpakdee2

, Manit Khiaolueang2

, Pattama Seancha2

, Tontrakan Nuansamlee2
,

Anucha Kamsom3 and Ratree Chaisorn4

https://doi.org/10.1186/s12245-023-00489-x

2023

peri irawan

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