Erdur Bulent, Ergin Ahmet, Turkcuer Ibrahim, Ergin Nesrin, Parlak Ismet, Serinken Mustafa, Bozkir Metin
Department of Emergency Medicine, Pamukkale University, Denizli, Turkey.
J Emerg Med. 2008 Oct;35(3):321-7. doi: 10.1016/j.jemermed.2007.06.029. Epub 2008 Feb 14.
The objective of this study was to evaluate the outcomes and associated factors for short-term success and long-term survival rates of resuscitated non-traumatic out-of-hospital cardiac arrest (OHCAs) in Denizli, Turkey. All non-traumatic OHCA patients from the Emergency Departments of the Pamukkale University and City Hospitals between the dates of January 1, 2004 and March 1, 2005 were included in this study. A successful outcome was defined as the return of spontaneous circulation or breathing, or evidence of a palpable pulse or a measurable blood pressure. Information on post-resuscitation long-term survival up to 9 months also was obtained by telephone. A total of 222 adults experiencing OHCAs were resuscitated. The number of successful outcomes was 85 (38.3%); 25 (11.2%) were discharged alive; and 21 (9.4%) were alive at the 9-month follow-up. The predicted mean arrest time was 11.7 min (95% confidence interval 10.27-13.2). Type of transportation to the Emergency Department (ambulance, 32.1% vs. private vehicle, 44.5%; p = 0.057), place of arrest (home, 32.6% vs. other, 44.0%; p = 0.08), first rhythm at the scene (asystole, 22.9% vs. ventricular fibrillation-pulseless ventricular tachycardia, 48.0%, vs. pulseless electrical activity, 12.5%; p = 0.056), and advanced cardiac life support starting time (the first 8 min, 46.8% vs. later than 8 min, 32.0%; p = 0.025) had an effect on outcome. Intensive public education for diagnosis and appropriate reporting of OHCA, the importance of bystander cardiopulmonary resuscitation, and the use of automated external defibrillators have an impact on the potential to increase the number of survivors.
本研究的目的是评估土耳其代尼兹利地区复苏成功的非创伤性院外心脏骤停(OHCA)患者的短期结局及相关因素,以及长期生存率。纳入了2004年1月1日至2005年3月1日期间来自棉花堡大学急诊部和市立医院的所有非创伤性OHCA患者。成功结局定义为自主循环或呼吸恢复,或可触及脉搏或可测量血压的证据。通过电话获取了复苏后长达9个月的长期生存信息。共有222例经历OHCA的成人患者被复苏。成功结局的数量为85例(38.3%);25例(11.2%)存活出院;21例(9.4%)在9个月随访时仍存活。预计平均骤停时间为11.7分钟(95%置信区间10.27 - 13.2)。转运至急诊部的方式(救护车,32.1%对私家车,44.5%;p = 0.057)、骤停地点(家中,32.6%对其他地点,44.0%;p = 0.08)、现场首次心律(心搏停止,22.9%对室颤 - 无脉性室性心动过速,48.0%,对无脉电活动,12.5%;p = 0.056)以及高级心脏生命支持开始时间(前8分钟,46.8%对8分钟后,32.0%;p = 0.025)对结局有影响。针对OHCA的诊断和适当报告、旁观者心肺复苏的重要性以及自动体外除颤器的使用进行强化公众教育,对增加幸存者数量的可能性有影响。