Iwami Taku, Hiraide Atsushi, Nakanishi Noriyuki, Hayashi Yasuyuki, Nishiuchi Tatsuya, Uejima Toshifumi, Morita Hiroshi, Shigemoto Tatsuhiro, Ikeuchi Hisashi, Matsusaka Masanori, Shinya Hiroshi, Yukioka Hidekazu, Sugimoto Hisashi
Department of General Medicine, Osaka University Graduate School of Medicine, Suita, Japan.
Resuscitation. 2006 May;69(2):221-8. doi: 10.1016/j.resuscitation.2005.08.018. Epub 2006 Mar 6.
To evaluate the outcome and the factors concerned with of out-of-hospital cardiac arrest patients according to the location of the collapse.
From May 1st, 1998 to April 30th, 2001, 15,211 consecutive out-of-hospital cardiac arrest cases considered for resuscitation were recorded. Of these cases 7540 arrests in subjects aged 18 years or older with cardiac aetiology were analyzed. The outcome and the related-factors, particularly incidence of ventricular fibrillation, were evaluated according to the location of the cardiac arrest. To analyze the factors that affect the incidence of ventricular fibrillation, a logistic regression model was used.
About three-quarters of out-of-hospital cardiac arrests occurred at private residences. The outcome and characteristics were significantly different according to the location of the arrest. Arrest patients in public or in the work place had a higher chance of being found in ventricular fibrillation and survival than those at a private residence. The multivariate adjusted odds ratios for ventricular fibrillation in a public or work place were significantly higher than that in private residences, after adjusting for covariates affecting initial rhythm, such as age, sex, witnessed status, bystander cardiopulmonary resuscitation, and response interval.
Although the majority of out-of-hospital cardiac arrests occur at private residences, arrests in public or in the work place had a higher chance of being found in ventricular fibrillation and survival than those at private residences. In order to establish a system to improve the outcome of out-of-hospital cardiac arrest, a well-considered strategy considering the location of arrest is necessary.
根据心脏骤停发生地点评估院外心脏骤停患者的预后及相关因素。
记录1998年5月1日至2001年4月30日期间连续的15211例考虑进行复苏的院外心脏骤停病例。对其中7540例18岁及以上有心脏病因的心脏骤停病例进行分析。根据心脏骤停的发生地点评估预后及相关因素，尤其是室颤发生率。使用逻辑回归模型分析影响室颤发生率的因素。
约四分之三的院外心脏骤停发生在私人住宅。根据心脏骤停发生地点的不同，预后和特征存在显著差异。在公共场所或工作场所发生心脏骤停的患者比在私人住宅发生心脏骤停的患者更有可能被发现处于室颤状态且存活。在调整了影响初始心律的协变量（如年龄、性别、是否有人目击、旁观者心肺复苏和反应间隔）后，公共场所或工作场所发生室颤的多因素调整比值比显著高于私人住宅。
尽管大多数院外心脏骤停发生在私人住宅，但在公共场所或工作场所发生心脏骤停的患者比在私人住宅发生心脏骤停的患者更有可能被发现处于室颤状态且存活。为建立改善院外心脏骤停预后的系统，有必要制定一项考虑心脏骤停发生地点的周全策略。
