Living above third floor reduces chances of surviving cardiac arrest, Canadian study suggests

While you might enjoy a better view from upper floor apartments, your chances of surviving a cardiac arrest get lower the higher you live, according to a new Canadian study.

The study published on Monday in the Canadian Medical Association Journal (CMAJ) examined five years of health data from the City of Toronto and Peel Regions, which were selected because of high population density and prevalence of high-rise residential buildings.

Researchers led by Ian Drennan, a paramedic with York Region’s paramedic services and a researcher with Rescu, based at St. Michael’s Hospital in Toronto wanted to see how “vertical delay to patient contact” affects survival rates in cases of cardiac arrest – when the heart suddenly stops beating.

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“As the number of high-rise buildings continues to increase and as population density rises in major urban centres, is important to determine the effect of delays to patient care in high-rise buildings on survival after cardiac arrest and to examine potential barriers to patient care in this setting,” said the study.

Drennan and his co-authors examined nearly 8,000 cases of cardiac arrest between 2006 and 2011 that occurred in private residences, including high-rise apartment buildings, houses and townhouses.

“With a rapidly deteriorating heart rhythm, and in the absence of defibrillation, cardiac arrests occurring on higher floors had a lower probability of survival because of the delay to patient contact by 911-initiated first responders,” said the study.

Those who lived on the ground or second floor fared best in the study. The data showed 4.2 per cent of them survived and were discharged from hospital. But survival dipped to 2.6 per cent for patients on or above the third floor. Above the 16th floor, the survival rate was “negligible” — 0.9 per cent.

There were no survivors among patients who went into cardiac arrest on or above the 25th floor.

Locked front doors, missing security staff and busy elevators lead to fatal delays where every second counts.

Another reason for decrease in survival rates in high-rise buildings were delays in getting the patient from his apartment to the ambulance and to hospital.

“There are prolonged periods during the extrication to the ambulance and en route to the hospital when the quality of CPR is suboptimal,” the study said. “As the patient is carried down stairs or is transported in an elevator, there is a shift in focus from providing continuous, high-quality CPR to removing the patient from the scene and getting him or her to the hospital quickly and safely. These disruptions in care could have a detrimental effect on patient outcome.”