Data of "Epidemiology of Out-of-Hospital Cardiac Arrests,Knowledge of Cardiovascular disease and Risk Factors in a regional setting in India: The Warangal Area out-of -hospital Cardiac Arrest Registry (WACAR)

Out-of-Hospital Cardiac Arrest (OHCA) is a global public health problem.While several OHCA registries are developed based on the Utstein template, there is limited data on OHCA from India.The Warangal Area out-of-hospital Cardiac Arrest Registry (WACAR) was designed to gain a better understanding of OHCA in a regional setting in India. The WACAR is a prospective one-year observational study of OHCA in Warangal area in the State of Telangana, India.OHCA cases were obtained from a regional Government Hospital, Mahatma Gandhi Memorial Hospital, a secondary care District Headquarters Hospital. Study subjects included all those above 18 years brought to the hospital with a history of non-traumatic OHCA of presumed cardiac origin from January 1, 2018 - December 31, 2018. A total of 814 individuals were included in the study for data analysis. The data are collected on a standard collection form designed with Utstein variables with additional data on clinical characteristics (modified Utstein template). It includes information on demographics, patient characteristics, risk factors, history of heart disease, comorbidities, prior symptoms, resuscitation characteristics, event timing, utilization of Emergency Medical Services (EMS) and outcomes. Study data were obtained from a review of hospital records. Medical staff involved in the care of OHCA were given data collection forms that were filled out in the emergency room setting. Information not obtained during initial emergency room evaluation was obtained from bystanders (including victim’s relatives and attendants) through telephone interviews. Results: A total of 1106 subjects of OHCA attended MGM Hospital during January 2018 and December 2018. After excluding those due to trauma, hanging, and burns, the sample size of OHCA was sized down to 926 subjects and 814 subjects with Presumed Cardiac etiology were included in the study for analysis. The results are tabulated into demographics, patient characteristics and resuscitation characteristics. Majority of subjects were male, with a median age of 60 years. The majority occurred in residential locations and sustained OHCA within one hour of symptom onset. Individuals with knowledge of CVD risk factors were more likely to report symptoms before OHCA. Data on resuscitation characteristics were inadequate. Conclusions: WACAR gives insight into the epidemiology of OHCA in India.The results of WACAR highlight that OHCA of cardiac etiology is a significant public health problem in India.The study demonstrated barriers involving patient knowledge of CVD ,risk factors, data collection, and access to health care. The study results also convey that the knowledge level of CVD risk factors and personal CVD disease have a significant impact on OHCA outcomes. The information from the WACAR registry, the first registry on OHCA in this setting points to the need for a Indian National OHCA Registry and might help to guide future steps to improve care OHCA in India.

院外心脏骤停（Out-of-Hospital Cardiac Arrest, OHCA）是全球性公共卫生问题。目前已有多项基于Utstein模板（Utstein template）构建的院外心脏骤停注册研究，但印度相关的院外心脏骤停数据仍较为匮乏。
瓦朗加尔地区院外心脏骤停注册研究（Warangal Area out-of-hospital Cardiac Arrest Registry, WACAR）旨在深入了解印度某区域的院外心脏骤停流行特征。本研究为前瞻性为期一年的观察性研究，对象为印度特伦甘纳邦瓦朗加尔地区的院外心脏骤停患者。研究病例取自地区级公立医院圣雄甘地纪念医院（Mahatma Gandhi Memorial Hospital）——一所二级护理区级中心医院。
研究纳入2018年1月1日至2018年12月31日期间送至该院、年龄≥18岁、疑似心源性非创伤性院外心脏骤停患者，最终共纳入814例受试者进行数据分析。
研究采用基于Utstein变量设计的标准化数据收集表，并补充了临床特征相关信息（改良Utstein模板）。收集内容包括人口学资料、患者特征、危险因素、心脏病病史、合并症、前驱症状、复苏相关特征、事件发生时间、急诊医疗服务（Emergency Medical Services, EMS）利用情况及预后转归。
研究数据通过查阅医院病历获取，参与患者救治的医护人员会在急诊环境下填写数据收集表；对于急诊初始评估未获取到的信息，则通过电话访谈旁观者（包括患者亲属及陪护人员）补充。
结果：2018年1月至12月期间，共有1106例院外心脏骤停患者就诊于圣雄甘地纪念医院。排除创伤、缢吊及烧伤所致的院外心脏骤停病例后，剩余926例患者，最终纳入814例疑似心源性病因的患者进行分析。研究结果按人口学特征、患者特征及复苏相关特征进行制表汇总。绝大多数受试者为男性，中位年龄为60岁。院外心脏骤停多发生于居住场所，且多在症状发作1小时内发生。知晓心血管疾病（Cardiovascular Disease, CVD）危险因素的患者，更易在院外心脏骤停发作前报告前驱症状。本研究中复苏相关特征的数据收集存在不足。
结论：WACAR为了解印度院外心脏骤停的流行病学特征提供了重要视角。研究结果凸显了心源性院外心脏骤停已成为印度不容忽视的公共卫生问题。本研究揭示了多项现存障碍：包括患者对心血管疾病危险因素的认知水平、数据收集现状以及医疗服务可及性等问题。同时研究结果表明，心血管疾病危险因素认知水平及个人心血管疾病病史对院外心脏骤停的预后具有显著影响。作为该地区首个院外心脏骤停注册研究，WACAR的数据提示亟需建立印度国家级院外心脏骤停注册系统，或可为未来改善印度院外心脏骤停救治工作提供指导方向。