Fitzpatrick B, Watt G C, Tunstall-Pedoe H
Department of Public Health, University of Glasgow.
Br Heart J. 1992 Mar;67(3):250-4. doi: 10.1136/hrt.67.3.250.
To determine the potential impact of emergency intervention strategies to prevent deaths from coronary heart disease outside hospital.
Analysis of routine medical and legal records of all persons dying of coronary heart disease in a defined population.
Glasgow City, north of the river Clyde, 1984.
420 people under 65 years for whom the underlying cause of death on the death certificate was coronary heart disease (ICD 410-414, 9th Revision).
Of the 296 deaths outside hospital, 73% occurred at home. The deaths of 40% of those who died outside hospital were not witnessed and these people could not have received prompt cardiopulmonary resuscitation. Only 16% of the witnesses of a death attempted cardiopulmonary resuscitation before the arrival of a doctor or an ambulance crew. Over half (53%) of the cases in which cardiopulmonary resuscitation could have been attempted by a witness, but was not attempted, death occurred in the presence of the spouse or other close relative. Death occurred in the presence of a duty doctor or the ambulance crew in a maximum of 5% of deaths outside hospital. Ninety one per cent of people were dead before a call for help was made.
Unless a greater proportion of patients receive cardiopulmonary resuscitation before emergency staff arrive at the scene the provision of emergency care staff with defibrillators is unlikely to have a significant impact on deaths outside hospital caused by coronary heart disease.
确定紧急干预策略对预防院外冠心病死亡的潜在影响。
对特定人群中所有死于冠心病的人员的常规医疗和法律记录进行分析。
1984年，克莱德河以北的格拉斯哥市。
420名65岁以下人员，其死亡证明上的根本死因是冠心病（国际疾病分类第九版，410 - 414）。
在296例院外死亡病例中，73%发生在家中。40%的院外死亡人员死亡时无人在场，这些人无法接受及时的心肺复苏。只有16%的死亡目击者在医生或救护人员到达之前尝试进行心肺复苏。在目击者本可尝试但未尝试心肺复苏的病例中，超过一半（53%）的死亡发生在配偶或其他近亲面前。在院外死亡病例中，最多5%的死亡发生在值班医生或救护人员面前。91%的人在呼救之前就已经死亡。
除非在急救人员到达现场之前有更大比例的患者接受心肺复苏，否则为急救人员配备除颤器不太可能对冠心病导致的院外死亡产生显著影响。
