J Korean Soc Emerg Med.  2022 Dec;33(6):524-531.

Analysis of reasons for the termination of resuscitation in non-traumatic out-of-hospital cardiac arrests before and after the COVID-19 pandemic

• Mok D
• Cho GC
• Cho Y

Abstract

Objective
The coronavirus disease 2019 (COVID-19) pandemic saw rising cases of out-of-hospital cardiac arrests. In addition, there was an increase in the number of cardiac arrest terminations. This study analyzes the 3-year status (2018 to 2020) of out-of-hospital cardiac arrest resuscitation terminations.
Methods
This study is a retrospective observational study based on the diary of 119 first aid activities in the Seoul area. Factors analyzed included patient demographics, history, location of occurrence, witness status, cause of cardiac arrest, electrocardiogram rhythm, reasons for cardiac arrest termination, and hospital transfer. Data obtained from the periods January 1, 2018, to December 31, 2019 (defined as the pre_COVID-19 period) and from January 1, 2020, to December 31, 2020 (defined as the COVID-19 period) were compared and analyzed.
Results
There was an increase in the number of terminated resuscitation cases during the study period. Most cases were elderly men with chronic disease who underwent asystole arrest at home. The reasons for the termination of resuscitation were obvious evidence of death, refusal of cardiopulmonary resuscitation (CPR) by the guardian, medical guidance, and cessation of prior life-sustaining treatment. During the COVID-19 pandemic, clear evidence of death and refusal of CPR by caregivers were statistically and significantly increased.
Conclusion
The results of this study indicate a rise in the number of cases subjected to termination of resuscitation during the COVID-19 period. It is, therefore, necessary to find a way to improve this situation.

Keyword

Cardiac arrest; Cardiopulmonary resuscitation; Termination of resuscitation; COVID-19