Out-of-hospital cardiac arrest in Qatar: epidemiology, management, and outcomes from a national registry study

Background: Out-of-hospital cardiac arrest (OHCA) remains a major global health challenge with persistently low survival rates despite advances in resuscitation science. This study aimed to evaluate the epidemiology, management, and outcomes of OHCA in Qatar using a national registry aligned with Utstein reporting standards. Methods: A prospective observational cohort study was conducted across Qatar, enrolling all adult patients (≥18 years) with non-traumatic OHCA in whom resuscitation was attempted by the national EMS provider. Data were collected from EMS records, hospital EMRs, and mortuary databases. Survivors were followed up at 30 days and 12 months for neurological and quality-of-life outcomes. The primary outcome was 30-day survival with a favourable neurological status (CPC 1-2). Results: Among 1238 OHCA cases, the median age was 52 years, and 80.5 % were male. Arrests occurred predominantly at home (64.0 %), with 61.8 % witnessed and 42.4 % receiving bystander CPR. Initial shockable rhythms were present in 29.7 %. ROSC was achieved in 44.8 %, survival to discharge was 17.8 %, and a favourable neurological outcome at 30 days was 13.5 %. Multivariable analysis identified witnessed arrest, prehospital defibrillation, and coronary reperfusion within 24 h as independent predictors of survival. The Utstein comparator group demonstrated a survival rate of 38.2 % and CPC 1-2 outcome in 32.8 % of cases. Conclusions: OHCA outcomes in Qatar have improved markedly, with survival and CPC 1-2 rates more than doubling compared with prior national estimates. Survival now approaches levels seen in high-performing international systems, although within a younger patient population. Consistent predictors of outcome-including witnessed arrest, early defibrillation, and timely coronary reperfusion-emphasise the critical targets for strengthening OHCA systems of care.