Cardiac arrest survival rate 'grim'
study: Less than 3% of Ottawa victims recover after heart stoppage

Joanne Laucius
The Ottawa Citizen

Friday, September 24, 2004

If you suffer cardiac arrest in Ottawa, chances are overwhelming you won't make it to the hospital alive.

Ottawa has one of the lowest cardiac arrest survival rates in Ontario -- 2.7 per cent -- according to a new study by a team of researchers in emergency medicine at the Ottawa Hospital Research Institute, the research arm of the Ottawa Hospital.

"It's grim," said lead researcher Dr. Christian Vaillancourt. "At lot of people never make it. The first place they see in the hospital is the morgue."

Cardiac arrest is more serious than a heart attack. Heart attack patients are often conscious. In cardiac arrest, the heart stops beating and the patient loses consciousness, stops normal breathing and loses pulse and blood pressure.

Survival rates all over the province are poor, according to the figures published in the Canadian Journal of Cardiology.

The provincial average survival rate is five per cent, but it is significantly higher in some cities, including Peterborough with 12.5 per cent, St. Catharines with 11.9 per cent and Sudbury with 10.3 per cent. On the other hand, Grimsby, Lindsay and Port Colborne all had a survival rate of zero.

Dr. Vaillancourt, who is also a member of the Ottawa Regional Heart Saver Committee, says the purpose of the study was to look at the figures, not to test a hypothesis. However, he suggests several reasons why survival rates are so low in Ottawa.

About 85 per cent of people who suffer cardiac arrest are at home, where the patient may be alone, or with someone who doesn't know how to perform CPR. Even if an emergency crew can get to the scene in minutes with a defibrillator, it may be too late unless CPR has been initiated first, he said .

According to the study, an emergency crew with a defibrillator was on the scene in Ottawa within eight minutes 94.2 per cent of the time, slightly higher than the provincial average of 92.6 per cent of the time.

But more people should be administering CPR while waiting for an ambulance and a defibrillator, said Dr. Vaillancourt.

"There's a lot of emphasis on machines and technology. If we don't know the basics, all the technology in the world is not going to help."

Bystander CPR was administered only in 11.1 per cent of the cases in Ottawa. "Nine times out of 10, no one is doing anything," said Dr. Vaillancourt.

In comparison, it was administered in 42.9 per cent of the cases in Grimsby, almost 39 per cent in Sarnia, 20 per cent in Burlington and 15.8 per cent in Sarnia. The provincial average was 14.7 per cent.

And Dr. Vaillancourt points out that while many people receive CPR training on the job, the people who really need it are the spouses and family of people over 60 years old, who are mostly likely to be with the victim. The average age of a cardiac arrest in Ottawa was 72, compared to a provincial average of 69.

Dr. Bob Roberts, president and CEO of the University of Ottawa Heart Institute, said some things have changed in Ottawa since 2002, the year on which the study is based.

In June, 911 operators started to give CPR instructions over the phone, something they already do in some other jurisdictions in Canada, said Dr. Roberts. As well, all heart attack patients are now routed directly to the Heart Institute.

Dr. Vaillancourt points out that some cities weren't included because they don't keep these kinds of statistics. Toronto, Hamilton, Calgary and Quebec City all could not participate. The 261 cardiac arrests in the Ottawa statistics occurred in the urban areas of Ottawa.

The study presents one good piece of news about Ottawa: the incidence rate of cardiac arrests here is relatively low.

Every year in Ottawa, 50 of every 100,000 people have cardiac arrest. Kingston had the highest rate in the province at 118 of every 100,000 people. The provincial average is 59 out of every 100,000 people.

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