Gräsner Jan-Thorsten, Meybohm Patrick, Fischer Matthias, Bein Berthold, Wnent Jan, Franz Rüdiger, Zander Josef, Lemke Hans, Bahr Jan, Jantzen Tanja, Messelken Martin, Dörges Volker, Böttiger Bernd W, Scholz Jens
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105 Kiel, Germany.
Resuscitation. 2009 Feb;80(2):199-203. doi: 10.1016/j.resuscitation.2008.10.008. Epub 2008 Dec 9.
Survival rate after out-of-hospital cardiac arrest (OHCA) has not significantly increased over the last decade. However, survival rate has been used as a quality benchmark for many emergency medical services. A uniform resuscitation registry may be advantageous for quality management of cardiopulmonary resuscitation (CPR). This study was conducted to evaluate the establishment of a national CPR registry in Germany.
A prospective cohort study was performed that included 469 patients who experienced OHCA requiring CPR in the metropolitan area of Dortmund, Germany. Cardiac arrest was defined as concomitant appearance of unconsciousness, apnoea or gasping and pulselessness. All data were collected via a secure and confidential paper-based method as the data set 'Preclinical care'.
Quality of data was classified as 'good' in 33.4%, 'moderate' in 48.4%, and 'bad' in 18.2% of the patients, respectively. Sixty-two percent had OHCA in private residences, 24% of the patients had a first monitored rhythm of ventricular fibrillation (VF) or ventricular tachycardia (VT), 35.2% had return of spontaneous circulation (ROSC) on scene, and patients presenting VF/VT as the first monitored rhythm had higher ROSC rates (51.3%) compared to patients with asystole (22.6%).
The data set 'Preclinical care' proved to be congruent with the Utstein style, provided further information for national and international comparisons, and enabled a detailed analysis. Optimisation of data collection and introduction of strict control mechanisms may further improve data quality.
在过去十年中,院外心脏骤停(OHCA)后的生存率并未显著提高。然而,生存率已被用作许多紧急医疗服务的质量基准。统一的复苏登记系统可能有利于心肺复苏(CPR)的质量管理。本研究旨在评估德国全国CPR登记系统的建立情况。
进行了一项前瞻性队列研究,纳入了德国多特蒙德市区469例发生OHCA且需要进行CPR的患者。心脏骤停定义为意识丧失、呼吸停止或喘息以及脉搏消失同时出现。所有数据通过一种安全且保密的纸质方法收集,作为数据集“院前护理”。
分别有33.4%、48.4%和18.2%的患者数据质量被分类为“良好”、“中等”和“差”。62%的患者在私人住宅发生OHCA,24%的患者首次监测到的心律为室颤(VF)或室性心动过速(VT),35.2%的患者在现场恢复自主循环(ROSC),与心搏停止患者(22.6%)相比,首次监测到的心律为VF/VT的患者ROSC率更高(51.3%)。
数据集“院前护理”被证明与乌斯坦风格一致,为国内和国际比较提供了更多信息,并能够进行详细分析。优化数据收集并引入严格的控制机制可能会进一步提高数据质量。