10/25/2008 05:12 am ET | Updated Nov 17, 2011

Where Not To Have A Heart Attack

What are your chances of surviving cardiac arrest outside a hospital setting? In a word, remote. But some doctors are turning that around, boosting survival rates to previously unthinkable levels. That's great news, right? Now for the bad news: your likelihood of being in that lucky group of survivors depends a great deal on where you live. "It's like real estate--location, location, location," says Dr. Arthur Sanders, a professor of emergency medicine at the University of Arizona's Sarver Heart Center.

That is the upshot of a study appearing this week in the Journal of the American Medical Association. Dr. Graham Nichol, director of the University of Washington's Center for Prehospital Emergency Care, surveyed the outcomes of cardiac arrest in 10 North American cities and states. Though outcomes for most medical procedures vary with factors like socioeconomic status, the differences in this study were even more pronounced than usual. Survival from site to site varied as much as fivefold. Patients in Seattle who were treated by emergency medical technicians (EMTs) pulled through in 16 percent of cases. In Alabama, they survived just 3 percent of the time.

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