Updated trends in the outcomes of out‐of‐hospital cardiac arrest from 2017–2021: Prior to and during the coronavirus disease (COVID‐19) pandemic

OBJECTIVE: This study aims to describe out‐of‐hospital cardiac arrest (OHCA) characteristics and trends before and during the coronavirus disease‐2019 (COVID‐19) pandemic in Taiwan. METHODS: We conducted a retrospective cohort study using a 5‐year interrupted time series analysis. Eligible adults with non‐traumatic OHCAs from January 2017 to December 2021 in 3 hospitals (university medical center, urban second‐tier hospital, and rural second‐tier hospital) were retrospectively enrolled. Variables were extracted from the emergency medical service reports and medical records. The years 2020 and 2021 were defined as the COVID‐19 pandemic period. Outcomes included survival to admission after a sustained return of spontaneous circulation, survival to hospital discharge, and good neurological outcomes (cerebral performance category score 1 or 2). RESULTS: We analyzed 2819 OHCA, including 1227 from a university medical center, 617 from an urban second‐tier hospital, and 975 from a rural second‐tier hospital. The mean age was 71 years old, and 60% of patients were males. During the COVID‐19 pandemic period, video‐assisted endotracheal tube intubation replaced the traditional direct laryngoscopy intubation. The trends of outcomes in the pre‐pandemic and pandemic periods varied among different hospitals. Compared with the pre‐pandemic period, the outcomes at the university medical center during the COVID‐19 pandemic were significantly poorer in several respects. The survival rate on admission dropped from 44.6% to 39.4% (P = 0.037), and the survival rate to hospital discharge fell from 17.5% to 14.9% (P = 0.042). Additionally, there was a notable decrease in patients' good neurological outcomes, declining from 13.2% to 9.7% (P = 0.048). In contrast, the outcomes in urban and rural second‐tier hospitals during the COVID‐19 pandemic did not significantly differ from those in the pre‐pandemic period. CONCLUSIONS: COVID‐19 may alter some resuscitation management in OHCAs. There were no overall significant differences in outcomes before and during COVID‐19 pandemic, but there were significant differences in outcomes when stratified by hospital types.