Claesson Andreas, Lindqvist Jonny, Herlitz Johan
Kungälv Ambulance Service, SE-442 40 Kungälv, Sweden; Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden; Centre for Pre-hospital Research, Western Sweden, Prehospen, University College of Borås and Sahlgrenska University Hospital, Gothenburg, Sweden.
Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
Resuscitation. 2014 May;85(5):644-8. doi: 10.1016/j.resuscitation.2014.02.006. Epub 2014 Feb 19.
To evaluate changes in characteristics and survival over time in out-of-hospital cardiac arrest (OHCA) due to drowning and describe factors of importance for survival.
Retrospectively reported and treated drowning cases reported to the Swedish OHCA registry between 1990 and 2012, n=529. The data were clustered into three seven-year intervals for comparisons of changes over time.
There were no changes in age, gender, witnessed status, shockable rhythm or place of OHCA during the time periods. Bystander CPR increased over time, 59% in interval 1992-1998, versus 74% in interval 2006-2012 (p=0.005). There was a decrease in delay between OHCA and calling for the Emergency Medical Service (EMS) over the years, while calling for the EMS to arrival increased in terms of time. Survival to hospital admission appears to have increased over the years (p=0.009), whereas survival to one month did not change significantly over time. In a multivariate analysis, witnessed status, female gender, bystander CPR, place-home and EMS response time were associated with survival to hospital admission. For survival to one month, place, age, shockable rhythm and logarithmised delay from calling for an ambulance to arrival were of significance for survival.
In OHCA due to drowning, over a period of 20 years, bystanders have called for help at an earlier stage and administered CPR more frequently in the past few years. Survival to hospital admission has increased, while shockable rhythm and early arrival of the EMS appear to be the most important factors for survival to one month.
评估溺水所致院外心脏骤停（OHCA）的特征及生存情况随时间的变化，并描述影响生存的重要因素。
回顾性报告并处理1990年至2012年期间上报至瑞典OHCA登记处的溺水病例，n = 529例。将数据分为三个七年时间段，以比较随时间的变化情况。
在各时间段内，年龄、性别、是否有目击者、可电击心律或OHCA发生地点均无变化。旁观者心肺复苏（CPR）随时间增加，1992 - 1998年时间段为59%，而2006 - 2012年时间段为74%（p = 0.005）。多年来，OHCA与呼叫紧急医疗服务（EMS）之间的延迟有所减少，而呼叫EMS至到达的时间增加。多年来入院生存率似乎有所提高（p = 0.009），而1个月生存率随时间无显著变化。在多变量分析中，是否有目击者、女性性别、旁观者CPR、发生地点 - 家中以及EMS反应时间与入院生存率相关。对于1个月生存率，发生地点、年龄、可电击心律以及呼叫救护车至到达的对数延迟对生存具有重要意义。
在因溺水导致的OHCA中，在20年期间，旁观者在更早阶段呼救，且在过去几年中更频繁地进行CPR。入院生存率有所提高，而可电击心律和EMS的早期到达似乎是1个月生存率的最重要因素。
