在法国巴黎2003年热浪期间，院外心脏骤停由医疗移动重症监护单元处理的情况有所增加，但心肌梗死并非如此。

Increase in out-of-hospital cardiac arrest attended by the medical mobile intensive care units, but not myocardial infarction, during the 2003 heat wave in Paris, France.

作者信息

Empana Jean-Philippe, Sauval Patrick, Ducimetiere Pierre, Tafflet Muriel, Carli Pierre, Jouven Xavier

机构信息

INSERM U970, Paris Cardiovascular Research Centre, Paris V University, Paris, France.

出版信息

Crit Care Med. 2009 Dec;37(12):3079-84. doi: 10.1097/CCM.0b013e3181b0868f.

DOI:10.1097/CCM.0b013e3181b0868f

PMID:19633540

Abstract

OBJECTIVES

To address the association between the 2003 heat wave in Paris (France) and the occurrence of out-of-hospital cardiac arrest.

DESIGN

: An analysis of the interventions of the medical mobile intensive care units of the City of Paris for out-of-hospital cardiac arrest and prehospital myocardial infarctions, which were routinely and prospectively computerized from January 1, 2000, to December 31, 2005.

SETTING

City of Paris, France.

PATIENTS

Participants were consecutive victims of witnessed out-of-hospital cardiac arrest due to heart disease and of ST-segment elevation myocardial infarction (STEMI) aged >or=18 yrs, who were attended by the medical mobile intensive care units (MICUs) of the City of Paris from January 1, 2000, to December 31, 2005.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

The numbers of out-of-hospital cardiac arrests and of STEMIs during the 2003 heat wave period (August 1 to August 14) were compared (Poisson regression analysis) with the respective average numbers during the same period in reference years 2000-2002 and 2004-2005 when there was no heat wave. Mean ages of the 3049 patients experiencing out-of-hospital cardiac arrest and the 2767 patients experiencing STEMI attended by the MICUs during the study period were 64.3 +/- 18.0 and 65.2 +/- 15.4, respectively, and two thirds were males. During the heat wave period, the number of out-of-hospital cardiac arrests (n = 40) increased 2.5-fold compared with the reference periods (n = 81 for 5 yrs; p < .001); this corresponded to an estimated relative rates of out-of-hospital cardiac arrests of 2.34 (95% confidence interval, 1.60-3.41), after adjustment for age and for gender. This increase was observed in both genders (p for interaction with gender = .48) but only in those who were aged >or=60 yrs (p for interaction with age = .005). No variation was found for myocardial infarctions during heat wave.

CONCLUSIONS

These data suggest that a heat wave may be associated with an increased risk of sudden cardiac death in the population.

摘要

目的

探讨2003年法国巴黎热浪与院外心脏骤停发生之间的关联。

设计

对2000年1月1日至2005年12月31日期间巴黎市医疗移动重症监护病房针对院外心脏骤停和院前心肌梗死的干预措施进行分析，这些数据已常规且前瞻性地录入计算机。

地点

法国巴黎市。

患者

研究对象为年龄≥18岁、因心脏病导致院外心脏骤停且有目击证人的连续受害者，以及ST段抬高型心肌梗死（STEMI）患者，他们在2000年1月1日至2005年12月31日期间由巴黎市医疗移动重症监护病房（MICU）接诊。

干预措施

无。

测量指标及主要结果

将2003年热浪期（8月1日至8月14日）院外心脏骤停和STEMI的发生数量与2000 - 2002年及2004 - 2005年无热浪的相应年份同期平均数量进行比较（采用泊松回归分析）。研究期间，MICU接诊的3049例院外心脏骤停患者和2767例STEMI患者的平均年龄分别为64.3±18.0岁和65.2±15.4岁，三分之二为男性。热浪期院外心脏骤停数量（n = 40）相较于参考期（5年共81例；p <.001）增加了2.5倍；在对年龄和性别进行调整后，院外心脏骤停的估计相对发生率为2.34（95%置信区间，1.60 - 3.41）。这种增加在男女两性中均有观察到（与性别交互作用的p值 =.48），但仅在年龄≥60岁的人群中出现（与年龄交互作用的p值 =.005）。热浪期间心肌梗死数量未发现变化。