Kang Jiwon, Kim Joonghee, Jo You Hwan, Kim Kyuseok, Lee Jae Hyuk, Kim Taeyun, Lee Jungyoup, Hwang Ji Eun, Jung Euigi
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Department of Emergency Medicine, Seoul National University Bundang Hospital 82, Gyeonggi-do 463-707, Republic of Korea.
Am J Emerg Med. 2015 Nov;33(11):1659-64. doi: 10.1016/j.ajem.2015.08.002. Epub 2015 Aug 5.
Emergency department (ED) overcrowding is a worldwide problem associated with adverse outcomes. This study was performed to investigate the association between ED overcrowding and the outcomes and quality of cardiopulmonary resuscitation for out-of-hospital cardiac arrest (OHCA).
Prospectively collected data including patients' demographics, Utstein factors, and outcomes on 608 consecutive OHCA patients at a single ED from January 2008 to December 2012 were retrospectively analyzed. The patients were categorized into 4 groups according to ED occupancy rate. The primary outcome was resuscitation outcome, a composite of rates of return of spontaneous circulation (ROSC), survival at discharge, and neurologic outcome at 6months. The secondary outcome was resuscitation quality assessed by time to advanced airway, time to first drug administration, resuscitation duration in refractory cases, and rate of initiation of therapeutic hypothermia after ROSC in the ED.
There was no significant difference in rates of ROSC, survival at discharge, and good neurologic outcome according to ED occupancy rate in the univariate and multivariate analyses (P>.05). In addition, ED overcrowding was not associated with resuscitation quality (P>.05).
Emergency department overcrowding was not associated with the outcomes of OHCA or resuscitation quality.
急诊科过度拥挤是一个全球性问题，与不良后果相关。本研究旨在调查急诊科过度拥挤与院外心脏骤停（OHCA）心肺复苏的结局及质量之间的关联。
回顾性分析2008年1月至2012年12月期间在一家急诊科连续收治的608例OHCA患者的前瞻性收集数据，包括患者人口统计学资料、Utstein因素及结局。根据急诊科占用率将患者分为4组。主要结局为复苏结局，即自主循环恢复（ROSC）率、出院生存率及6个月时神经功能结局的综合指标。次要结局为通过建立高级气道时间、首次给药时间、难治性病例的复苏持续时间以及急诊科ROSC后治疗性低温启动率评估的复苏质量。
在单因素和多因素分析中，根据急诊科占用率，ROSC率、出院生存率及良好神经功能结局方面均无显著差异（P>0.05）。此外，急诊科过度拥挤与复苏质量无关（P>0.05）。
急诊科过度拥挤与OHCA结局或复苏质量无关。
