Incidence, mortality, causes of sudden cardiac arrest: cardiopulmonary resuscitation in the world and reality in Ukraine

The study aimed to analyze official data from the European Resuscitation Council on out-of-hospital sudden cardiac arrest worldwide and in Ukraine among military personnel during combat, considering the causes, duration from injury to the start of resuscitation, and complications according to the data from level II surgical hospital (stage II of medical evacuation) of the Armed Forces of Ukraine. The study was conducted at a mobile hospital (stage II of medical evacuation) in the most active combat zones during June-August 2024. The analysis of resuscitation measures was conducted — cardiopulmonary resuscitation for 36 military personnel at stage II of medical evacuation of the Armed Forces of Ukraine. A retrospective review of 86 domestic and foreign scientific papers was performed using the PubMed and Google Scholar databases. After reviewing the articles and familiarizing with their full texts, 35 sour­ces on cardiopulmonary resuscitation in individuals with out-of-hospital cardiac arrest worldwide and during armed conflicts were selected. The search depth covered the period from 2004 to 2024. The bibliosemantic, systems analysis, and statistical methods were used in the work. The most common causes of out-of-hospital cardiac arrest were chest trauma, in particular gunshot wounds, accompanied by the development of hydro- and pneumothorax, as well as hemopericardium (21.6 %), gunshot wounds that caused massive bleeding (21.5 %), lower limb amputation (20.5 %), thoracoabdominal injuries (20.4 %), and poisoning by combustion products (16.0 %). The duration of resuscitation measures for out-of-hospital cardiac arrest was 5 minutes in 11.1 %, 10 minutes in 13.8 %, 20 minutes in 8.3 %, 45 minutes in 36.5 %, 60 minutes in 16.6 %, 70 minutes in 2.7 %, 90 minutes in 5.5 %, and 120 minutes in 5.5 % of cases. Successful resuscitation measures were carried out in 63.9 % of military personnel, and in 36.1 % the outcome was negative. Conclusions. Worldwide, the annual incidence of out-of-hospital cardiac arrest is approximately 50–60 cases per 100 thousand people, with 72.0 % of cardiac arrests occurring at home, 15.0 % at work, and the most common mechanism is ventricular fibrillation — 17 per 100 thousand people per year.