Prevalence of advance directives and impact on advanced life support in out-of-hospital cardiac arrest victims

Abstract Aim To evaluate the prevalence of advance directives and their impact on the management of out-of-hospital cardiac arrest (OHCA) victims. Methods We analyzed data extracted from the French national registry of adult OHCA patients (ReAC). The data concerned the emergency medical services (EMS) of a Paris suburb over the period 01/01/2013 to 30/11/2015. The primary endpoint was the prevalence of advance directives. Secondary endpoints were the characteristics of the population, of cardiac arrest, and of basic life support as well as outcomes in patients with or without advance directives. Results Advance directives were available for 148/1985 (7.5%) of OHCA patients. Advanced life support was given to 35 patients with directives and 941 patients without (24% vs. 51%, p p  = 0.3). Among patients with advance directives, only one was admitted to hospital. He/she died within 24 h of admission. Conclusion Advance directives were accessed by EMS for 7.5% OHCA patients. Despite their availability, advanced life support was provided to 24% of patients.