The survival rate after a cardiac arrest could be much better if the first aid gestures were known to all

2023-08-27 06:30:10

Cardiac massage demonstration in Bourgoin-Jallieu (Isère) organized by the French Red Cross, May 18, 2019. ALLILI MOURAD/SIPA

The number of sudden deaths from cardiac arrest is “hopelessly stable” in France as in the world for ten years. The finding comes from Eloi Marijon, head of the cardiology department at the European Georges-Pompidou Hospital (HEGP) in Paris. In France, heart attacks cause approximately 40,000 deaths per year, according to the expert. A number resulting from the extrapolation, on a national scale, of data from the register of the Sudden Death Expertise Center of the HEGP, which lists in real time since 2011 all extra-hospital cardiac arrests, in Paris and in the inner suburbs . The average age is 68, and these deaths are twice as common among men.

On a European scale, the number of sudden deaths in adults has been estimated at nearly 250,000 per year, according to a 2022 study. Which, extrapolated on a global scale, would represent 4 million to 5 million deaths. every year. Three times out of four, sudden death in adults occurs during a myocardial infarction or in connection with a pathology arteries that supply the heart. In 20% of cases, damage to the heart muscle, hereditary or acquired, is involved. The remaining 5% are linked to heart rhythm disorders, most often hereditary – especially in younger people. Apart from cardiac causes, a minority of sudden deaths may result from cerebral hemorrhages or overdoses.

How can this burden be reduced? Sunday August 27, the magazine The Lancet publishes a series of recommendations to better prevent these deaths. A commission of thirty international experts, coordinated by Eloi Marijon, representing all the disciplines concerned – cardiology, electrophysiology, emergency medicine, resuscitation, forensic medicine, psychiatry, genetics, public health and economics – has been working on the subject since 2020, initiated by the journal. “Despite all the technological and medical advances of the 21st^e century, the survival rate from out-of-hospital cardiac arrest remains below 10% in most parts of the world”, underlines the committee of Lancetwho judges this stagnation “unacceptable”. In the four departments of Paris and the inner suburbs, for example, this rate has gone from 5% to 6% in 2011 to 7% to 8% in 2021 – minimal progress.

Practice “lifesaving gestures”

However, survival rates following cardiac arrest can be “extremely good, approaching 70%” in favorable circumstances, notes Eloi Marijon. What makes the difference ? The immediate practice of “lifesaving gestures” : cardiac massage or the use of a general public defibrillator. « After a cardiac arrest, every minute spent without cardiac massage decreases the chances of survival by 10%”, recalls Lionel Lamhaut, emergency physician, co-director of SAMU 75 and head of the anesthesia-resuscitation department at the Necker hospital in Paris. But, on average, in France, firefighters take thirteen minutes to arrive at the scene of a cardiac arrest. « Therefore, if no one does a massage before help arrives, the affected person has a very small chance of recovery. »

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