Key result
EMS-treated out-of-hospital cardiac arrest yields pre-hospital ROSC in ~10% of cases with ~1% 30-day survival.
Why the study?
Manual, non-standardised data collection of OHCA in Penang was limited and unsustainable, necessitating a systematic registry for quality improvement.
Cohort (n=5,087)
The establishment of an OHCA registry in Penang demonstrates low survival rates, highlighting prolonged EMS response times and low bystander AED use as crucial targets for systemic intervention.
Answers are grounded in this paper and cite their sources.
Low survival in this Penang OHCA cohort identifies EMS delays and AED gaps as targets; leaves open whether interventions improve outcomes in similar settings.
Introduction: In Penang, Malaysia, an out-of-hospital cardiac arrest (OHCA) registry was established in 2023 to facilitate systematic, sustainable collection and analysis of OHCA cases across the state. This paper describes the development of key data collection processes and presents a descriptive analysis of data captured during the first year of establishment. Methods: An online platform (myOHCA2.0) was developed to abstract data from existing pre-hospital and in-hospital electronic systems, capturing patient, event, response, and outcome characteristics in accordance with the Utstein template. OHCAs occurring between 1st April 2023 and 31st March 2024 were analysed. Results: A total of 5087 OHCA cases were included in the descriptive analysis. Patients were predominantly male (54.8%) with a median age of 73 years [IQR 61-83]. In total, 16.3% had a resuscitation attempt by EMS. A majority of patients were of either Chinese (52.2%) or Malay (33.0%) ethnicity, and most arrests occurred at home (92.8%). The median ambulance response time was 21 min [IQR 16-29]. Among EMS-attempted resuscitation cases, 47.2% were witnessed by laypersons, bystander CPR was provided in 43.5%, and an AED was applied in only 7.1%. Return of spontaneous circulation (ROSC) was achieved in 10.3% of this cohort, while 30-day survival was 1.3%. Conclusion: OHCA survival rates in Penang remain low despite bystander CPR being performed in nearly half of EMS-attempted resuscitation cases. Prolonged EMS response times and low rates of AED deployment represent targets for intervention.
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Leong et al. (2026) conducted a cohort in Out-of-hospital cardiac arrest (n=5,087). Out-of-hospital cardiac arrest was evaluated on Any EMS-documented return of spontaneous circulation (ROSC) before Emergency Department arrival. Among 5,087 out-of-hospital cardiac arrest cases, EMS attempted resuscitation in 16.3% of cases, yielding a return of spontaneous circulation in 10.3% of the treated cohort and an overall 30-day survival rate of 1.3%.
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