Abstract Sa1206: Chicago improves its Out-of-Hospital Cardiac Arrest Survival

Background: Illinois Heart Rescue began monitoring out-of-hospital cardiac arrest (OHCA) data in 2013, and since then the program has expanded from one Emergency Medical Services (EMS) agency to 110 agencies and 118 hospitals in Illinois that report to Cardiac Arrest Registry to Enhance Survival (CARES). In Chicago, apart from community bystander cardiopulmonary resuscitation trainings and resuscitation academy trainings, the program provides audits and feedback for 911 calls, and critical insights to the hospitals.

Aim: Our aim was to assess OHCA survival rates in Chicago for 2023 and compare those to prior years.

Methods: We included non-traumatic adult OHCA served by Chicago EMS and reported to CARES between 2013 to 2023. Cases that occurred in a healthcare facility or a nursing home were excluded. Rates were generated; percentage changes and trends were assessed.

Results: Of the 23,688 cases from 2013-2023 in Chicago, 2470 cases occurred in 2023. The highest rates of survival to hospital admission (STHA, 30.6%), survival to hospital discharge (STHD, 10.6%), favorable neurologic survival (6.6%) and Utstein survival to hospital discharge (37.8%) since 2013 were recorded in 2023, and particularly since 2020 the survival rates increased consistently. From 2020 to 2023, the STHA increased by 44% (p for trend=0.048), STHD by 76% (p=0.03), favorable neurologic survival by 91% (p=0.03), and Utstein survival by 93% (p=0.02). Overall survival rates were similarly increased in both men and women for the most part. STHD increased in men by 95%, and in women by 48% from 2020 to 2023, with the survival rate becoming comparable in the two genders in 2023 (10.8% in men vs. 10.2% in women). Similarly, the rate of favorable neurologic survival increased in both, but the increase was steeper in men with a higher survival rate in men (7.2% vs. 5.7% in women) in 2023. Utstein survival also improved significantly in men and reached 40% in 2023 (with an increase of 152% from 2020 to 2023, p=0.004). By race and ethnicity, STHD and favorable neurologic survival increased consistently in Hispanic and Black cases from 2020 to 2023.

Conclusion: Chicago experienced a significant increase in OHCA survival. This is a result of concerted efforts of Chicago Fire Department/EMS, hospitals and community with the support of Illinois Heart Rescue. As a result of these efforts, the survival rates in Chicago are now comparable to or exceed the national rates.