Department of Cardiology, Karolinska Institutet, South Hospital, Stockholm, Sweden.
Scand J Trauma Resusc Emerg Med. 2009 Apr 17;17:18. doi: 10.1186/1757-7241-17-18.
A large proportion of patients who suffer from out of hospital cardiac arrest (OHCA) outside home are theoretically candidates for public access defibrillation (PAD). We describe the change in characteristics and outcome among these candidates in a 14 years perspective in Sweden.
All patients who suffered an OHCA in whom cardiopulmonary resuscitation (CPR) was attempted between 1992 and 2005 and who were included in the Swedish Cardiac Arrest Register (SCAR). We included patients in the survey if OHCA took place outside home excluding crew witnessed cases and those taken place in a nursing home.
26% of all OHCAs (10133 patients out of 38710 patients) fulfilled the inclusion criteria. Within this group, the number of patients each year varied between 530 and 896 and the median age decreased from 68 years in 1992 to 64 years in 2005 (p for trend = 0.003). The proportion of patients who received bystander CPR increased from 47% in 1992 to 58% in 2005 (p for trend < 0.0001). The proportion of patients found in ventricular fibrillation (VF) declined from 56% to 50% among witnessed cases (p for trend < 0.0001) and a significant (p < 0.0001) decline was also seen among non witnessed cases.The median time from cardiac arrest to defibrillation among witnessed cases was 12 min in 1992 and 10 min in 2005 (p for trend = 0.029). Survival to one month among all patients increased from 8.1% to 14.0% (p for trend = 0.01). Among patients found in a shockable rhythm survival increased from 15.3% in 1992 to 27.0% in 2005 (p for trend < 0.0001).
In Sweden, there was a change in characteristics and outcome among patients who suffer OHCA outside home. Among these patients, bystander CPR increased, but the occurrence of VF decreased. One-month survival increased moderately overall and highly significantly among patients found in VF, even though the time to defibrillation changed only moderately.
大量院外心脏骤停（OHCA）患者理论上是公众可获取除颤（PAD）的候选者，这些患者中，我们描述了 14 年来瑞典候选者的特征和结局变化。
纳入 1992 至 2005 年期间瑞典心脏骤停注册研究（SCAR）中尝试心肺复苏（CPR）的所有 OHCA 患者。排除船员目击病例和疗养院发生的病例，将 OHCA 发生在院外的患者纳入调查。
38710 例 OHCA 患者中，26%（10133 例）符合纳入标准。在这一组中，每年患者数量在 530 至 896 例之间，中位年龄从 1992 年的 68 岁降至 2005 年的 64 岁（趋势 P=0.003）。旁观者 CPR 的比例从 1992 年的 47%增加到 2005 年的 58%（趋势 P<0.0001）。目击病例中心室颤动（VF）的比例从 56%降至 50%（趋势 P<0.0001），非目击病例中也显著下降（P<0.0001）。目击病例中从心脏骤停到除颤的中位时间从 1992 年的 12 分钟缩短至 2005 年的 10 分钟（趋势 P=0.029）。所有患者一个月的生存率从 8.1%增加到 14.0%（趋势 P=0.01）。在可除颤节律中发现的患者的生存率从 1992 年的 15.3%增加到 2005 年的 27.0%（趋势 P<0.0001）。
瑞典院外 OHCA 患者的特征和结局发生了变化。在这些患者中，旁观者 CPR 增加，但 VF 的发生减少。整体一个月生存率适度增加，VF 中发现的患者生存率显著增加，尽管除颤时间仅略有变化。
