Intra-hospital factors affecting survival to admission in out-of-hospital cardiac arrest: an exploratory cross-sectional study

Objectives Out-of-hospital cardiac arrest (OHCA) presents a major medical challenge globally, with persistently low survival rates. Developing countries generally experience even lower survival outcomes. Various intra-hospital factors may affect survival to admission, but their roles are insufficiently studied in the management of OHCA, particularly in Indonesia. This study investigated intra-hospital factors associated with survival to admission among OHCA patients treated in the emergency department of Saiful Anwar General Hospital, Malang, East Java, Indonesia. Methods An exploratory cross-sectional study was conducted using data from the Pan-Asian Resuscitation Outcomes Study (PAROS) OHCA registry between 2015 and 2023. The study included adult cases of OHCA, excluding traumatic arrests, pediatric patients, and coronavirus disease 2019 (COVID-19) cases. Variables assessed included patient demographics, comorbidities, cardiac arrest characteristics, and specific interventions such as defibrillation, advanced airway management, and cardiac catheterization. Statistical analyses comprised bivariate and multivariable logistic regression to identify factors significantly associated with survival to admission. Results A total of 428 cases were analyzed. The overall survival to admission rate was 7.24%. Advanced airway management (odds ratio [OR], 13.286; 95% confidence interval [CI], 3.928–44.937), defibrillation (OR, 8.400; 95% CI, 1.909–36.968), and cardiac catheterization (OR, 13.307; 95% CI, 1.089–162.635) were each significantly associated with higher survival to admission. Conversely, hypertension negatively affected survival (OR, 0.369; 95% CI, 0.149–0.912). Conclusion Intra-hospital interventions such as advanced airway management and cardiac catheterization significantly increase the likelihood of survival to admission for OHCA patients. However, comorbid hypertension reduces the chance of survival. These results underscore the importance of optimizing in-hospital care protocols among OHCA patients.