FIRE COMMISSIONER NICHOLAS SCOPPETTA, NEW YORK ACADEMY OF MEDICINE AND AMERICAN HEART ASSOCIATION ANNOUNCE RESULTS OF THE PHENYCS CARDIAC ARREST STUDY

Study shows cardiac arrest survival rates increase citywide, but need for increased and
continued CPR education in communities remains.

Fire Commissioner Nicholas Scoppetta today was joined at Fire Department headquarters in Brooklyn by Dr. Sandro Galea from The New York Academy of Medicine (the Academy), to announce the results of the “Pre-Hospital Evaluation of New York Cardiac Survival” (PHENYCS) study. Today compared to a decade ago, more people in New York City are surviving after experiencing cardiac arrest. From April 2002 through March 2003, the study found that 134 people were saved as a result of EMS pre-hospital intervention. The results were presented at a poster session yesterday at the American Heart Association’s Scientific Sessions 2004 in New Orleans, Louisiana.

Funded by the American Heart Association and in collaboration with the FDNY, the Academy, and the Center for Pediatric Emergency Medicine, the 12-month study was designed to assess the survival rates of victims who suffered cardiac arrest in New York City (cardiac arrest is characterized as a complete loss of heart function) and compare those rates to a similar study conducted 10 years ago. From 1990 to 1991, the survival rate for patients suffering from cardiac arrest was 2.2 percent. Today, that figure has risen to 3.1 percent – an increase of 40 percent – despite an increasingly aging population in the City. These survival figures are on par with other major cities nationwide and globally. The survival rate in Osaka, Japan (population 8.8 million) from 1998 to 2001 was 1.8 percent and in Singapore (population 4.1 million) from 2001 to 2002 the survival rate was 1 percent. Domestically, in Chicago for 1987 (the most recent data available) the survival rate was 1.7 percent.

“Over the last 10 years we have seen a number of significant changes in the way we provide pre-hospital emergency medical care in New York City,” said Commissioner Scoppetta. “We’ve cut our response times to cardiac emergencies in half, created a citywide First Responder/Defibrillator program and nearly doubled the amount of a defibrillator equipped units on the streets. The fact is, we’re saving more victims of cardiac arrest today than we were 10 years ago.”

Since the merger of the Fire Department and the Emergency Medical Service in 1996, the response time to segment one medical emergencies (cardiac arrest) has decreased by nearly 50 percent from approximately 7.9 minutes to 4.1 minutes in 2002. This is due in large part the increase in ambulance resources allocated to the 9-1-1 system as well as the implementation of a first responder/defibrillator program for firefighters staffing engine companies.

The study also highlighted the low-prevalence of CPR knowledge and training among the general population and called for increased educational programs to promote basic first aid in communities. The majority of cardiac arrests occur in the home and the ability to administer CPR as quickly as possible is critical to increasing the patient’s chances of survival.

“The American Heart Association funded the first study in the early 90’s and most recently funded the PHENYCS study because we thought it was now vital to have current data on out of hospital cardiac arrest survival rates,” said Diane M. Sixsmith, M.D., Chair of the Association’s advisory committee for the PHENYCS study and Chairman of Emergency Medicine at The New York Hospital & Medical Center of Queens. “We wanted to see what factors influenced survival rates and non-survival rates. Understanding the chain of survival and how to strengthen its links which includes early access to 9-1-1, early CPR and early defibrillation can only improve survival rates.”

“Survival for out-of-hospital cardiac arrest in New York City has improved over the past decade and reflects some of the enhancements to the emergency medical system that have been implemented,” said the Academy’s Dr. Galea, senior investigator on the study and Associate Director of the Academy’s Center for Urban Epidemiologic Studies. “Our data shows that there’s still room for improvement. I’m hopeful that in the years to come, even more lives will be saved.”

Researchers analyzed 4,653 cardiac arrest cases in New York City over a one-year period with a presumed primary cardiac etiology. Among these, 1,746 (37.5%) patients had the onset of their cardiac arrest symptoms witnessed by a bystander. In nearly half of all these cases (44.4%) this bystander was a family member. Among these cardiac arrests, 43.4% were 75 years of age or older; 54.6% were men; 31.2% were African-American; 16.4% were Latino; and 46.3% were Caucasian. Out of the all the cases, 2,091 or 44.9% of victims had a previous heart condition.

Adjusting for the changes in the characteristics of the New York City population over the past 10 years (so that the data can be accurately compared to the survival rate from the original study), the survival rate from out-of-hospital cardiac arrest in New York City in 2002-2003 was 3.1%. This represents a survival rate of approximately 40% higher than the 2.2% overall reported in 1990-1991. Among those patients from 2002 to 2003 who had a cardiac arrest and had someone witness the arrest, (1,746 patients), 62 patients survived, which is 3.6%. The survival rate in all sub-groups increased in the past 10 years.

Trained paramedics collected data for the study by interviewing all of the FDNY personnel who were involved in caring for a cardiac arrest patient and collecting key information about the patient, including what happened during the arrest, and whether the patient was transported to a hospital. Data from the FDNY quality control system was used to assess if these patients were admitted to hospital and if they lived for more than 30 days after discharge from the hospital. The study found that 134 patients were living for more than 30 days after hospital discharge.

About the New York Academy of Medicine
The New York Academy of Medicine is a non-profit institution founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on disadvantaged urban populations. Visit us online at www.nyam.org.

About the American Heart Association
Since 1924, the American Heart Association has helped protect people of all ages and ethnicities from the ravages of heart disease and stroke. These diseases, the nation’s No. 1 and No. 3 killers, claim more than 930,000 American lives a year. The association invested more than $407 million in fiscal year 2002-03 for research, professional and public education, advocacy and community service programs so people across America can live stronger, longer lives. Visit us online at www.americanheart.org.

Press Contact:
Edward Skyler / Robert Lawson (212) 788-2958
Francis X. Gribbon / David Biling (FDNY) (718) 999-2056

http://www.nyc.gov/fdny