Evaluating the impact of emergency interventions and geographical disparities on out-of-hospital cardiac arrest outcomes: A retrospective analysis from Poland

Out-of-hospital cardiac arrest (OHCA) is a global health challenge, with survival outcomes highly dependent on timely and effective emergency interventions. This study evaluates the impact of defibrillation, intubation, and intravenous pharmacotherapy on achieving return of spontaneous circulation (ROSC) in OHCA cases, with a focus on geographical and etiological variability. This retrospective analysis included 4361 OHCA cases recorded in the Lublin Voivodeship, Poland, between 2014 and 2017. Data from medical records were analyzed using Chi-square tests and logistic regression to assess associations between emergency interventions and ROSC. The primary outcome was achieving ROSC, while independent variables included intervention types, geographical location, and OHCA etiology. The study population consisted of 4361 OHCA patients, with a mean age of 68 years; 60.4% were male. ROSC was achieved in 41.8% of cases. Defibrillation significantly improved ROSC rates (P < .001), with notable success disparities between urban centers (52.94%) and rural areas (33%). Intubation positively influenced ROSC (P = .0226), particularly in cases with unknown etiology, while the impact of intravenous pharmacotherapy was less statistically significant (P = .078). Geographic and resource disparities significantly affected intervention effectiveness. Timely defibrillation, effective airway management, and tailored emergency protocols are critical for improving OHCA outcomes. Expanding public access to defibrillators, addressing disparities in emergency medical services training and resource allocation, and integrating predictive analytics in emergency response planning are recommended. Future research should validate these findings using prospective designs and evaluate advanced technologies in diverse settings.