Mathiesen WT, et al. - Researchers determined the impact of prehospital system factors, bystander cardiopulmonary resuscitation (CPR), emergency medical services (EMS), response time, and EMS physician attendance on out-of-hospital cardiac arrest (OHCA) survival in a mixed urban/rural region with a high survival rate after OHCA. Relative to rural areas, higher OHCA survival was reported in urban areas. Between urban and rural areas, the impact of bystander CPR, EMS response time and EMS physician attendance on survival varied. The highest influence of modifiable factors on survival was noted in the prehospital stage of care. In patients surviving to hospital admission, no significant difference in in-hospital mortality or in 1 year mortality was seen between OHCA in rural vs urban areas.