In the Middle East there are a selected number of cardiac registries, with the goal of monitoring the incidence of cardiovascular events and their treatment in a pre-hospital setting. Specifically cardiac arrest (CA) registries allow surveillance of who is affected, when and where the CA occurred, which elements of the EMS system are effective and operational and those that need addressing, and it allows identification of how changes can be implemented. A recent study by El Sayed et al (2013) found that the out of hospital cardiac arrest (OHCA) survival rate in Beirut, Lebanon, is 5%. One of the critical factors to reduce OHCA mortality is the collection of data from the pre-hospital care system; these records will not only aim to improve OHCA outcomes but also address issues with the pre-hospital care system and thus allow for improvements in prevention and treatment programs. Although cardiac arrests are the leading cause of death in the US, in Lebanon the numbers are lacking. Through the creation of an alliance between AUBMC, local EMS (Red Cross), Lebanese Syndicate of Hospitals and the Ministry of Health, we can demonstrate that surveillance of OHCA and monitoring of improved EMS and pre-hospital care can drive process improvement, improve disparities in out of hospital care and save lives. This project has the potential to rapidly proceed to a pre-hospital and EMS system that can be adopted nationally whilst simultaneously facilitating cooperation between agencies, jurisdictions and organizations for the benefit of individual patients and the public health system.

All patients for whom the EMS system was activated and who are identified to have sustained sudden cardiac arrest of presumed cardiac etiology will be included in the registry.  

All patients who sustain a sudden cardiac arrest in the out of hospital setting and for whom the EMS system was activated will be included in the registry.  EMS services and emergency departments treat non-selected patient populations. Everyone who sustains an out of hospital cardiac arrest is treated, without regard for age, race, gender, ethnicity, or ability to pay.

The Lebanese syndicate of hospitals will be asked to facilitate data collection from receiving hospitals (Greater Beirut Area) and identify a contact person in each hospital in Beirut to provide the registry team with follow up on patients’ outcomes.

Proposed sample composition – All patients requiring care for cardiac arrest in the geographic confines of the study area will be eligible for entry into the ongoing registry. There is no sample per se. The population size of the greater Beirut area is estimated to be home to approximately 1.2 million people. This registry will oversee all OCHA that occur within this geographic location.