Irfan Furqan B, Bhutta Zain Ali, Castren Maaret, Straney Lahn, Djarv Therese, Tariq Tooba, Thomas Stephen Hodges, Alinier Guillaume, Al Shaikh Loua, Owen Robert Campbell, Al Suwaidi Jassim, Shuaib Ashfaq, Singh Rajvir, Cameron Peter Alistair
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83 Stockholm, Sweden; Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
Department of Emergency Medicine, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
Int J Cardiol. 2016 Nov 15;223:1007-1013. doi: 10.1016/j.ijcard.2016.08.299. Epub 2016 Aug 24.
Out-of-hospital cardiac arrest (OHCA) studies from the Middle East and Asian region are limited. This study describes the epidemiology, emergency health services, and outcomes of OHCA in Qatar.
This was a prospective nationwide population-based observational study on OHCA patients in Qatar according to Utstein style guidelines, from June 2012 to May 2013. Data was collected from various sources; the national emergency medical service, 4 emergency departments, and 8 public hospitals.
The annual crude incidence of presumed cardiac OHCA attended by EMS was 23.5 per 100,000. The age-sex standardized incidence was 87.8 per 100,000 population. Of the 447 OHCA patients included in the final analysis, most were male (n=360, 80.5%) with median age of 51years (IQR=39-66). Frequently observed nationalities were Qatari (n=89, 19.9%), Indian (n=74, 16.6%) and Nepalese (n=52, 11.6%). Bystander cardiopulmonary resuscitation (CPR) was carried out in 92 (20.6%) OHCA patients. Survival rate was 8.1% (n=36) and multivariable logistic regression indicated that initial shockable rhythm (OR 13.4, 95% CI 5.4-33.3, p=0.001) was associated with higher odds of survival while male gender (OR 0.27, 95% CI 0.1-0.8, p=0.01) and advanced cardiac life support (ACLS) (OR 0.15, 95% CI 0.04-0.5, p=0.02) were associated with lower odds of survival.
Standardized incidence and survival rates were comparable to Western countries. Although expatriates comprise more than 80% of the population, Qataris contributed 20% of the total cardiac arrests observed. There are significant opportunities to improve outcomes, including community-based CPR and defibrillation training.
来自中东和亚洲地区的院外心脏骤停（OHCA）研究有限。本研究描述了卡塔尔OHCA的流行病学、紧急医疗服务及结局。
这是一项依据Utstein风格指南，于2012年6月至2013年5月在卡塔尔对OHCA患者进行的前瞻性全国性基于人群的观察性研究。数据从多个来源收集；国家紧急医疗服务机构、4个急诊科和8家公立医院。
由紧急医疗服务机构处理的推测为心脏性OHCA的年粗发病率为每10万人23.5例。年龄 - 性别标准化发病率为每10万人口87.8例。在最终分析纳入的447例OHCA患者中，大多数为男性（n = 360，80.5%），中位年龄为51岁（四分位间距 = 39 - 66）。常见国籍为卡塔尔人（n = 89，19.9%）、印度人（n = 74，16.6%）和尼泊尔人（n = 52，11.6%）。92例（20.6%）OHCA患者接受了旁观者心肺复苏（CPR）。生存率为8.1%（n = 36），多变量逻辑回归表明初始可电击心律（比值比13.4，95%置信区间5.4 - 33.3，p = 0.001）与较高的生存几率相关，而男性性别（比值比0.27，95%置信区间0.1 - 0.8，p = 0.01）和高级心脏生命支持（ACLS）（比值比0.15，95%置信区间0.04 - 0.5，p = 0.02）与较低的生存几率相关。
标准化发病率和生存率与西方国家相当。尽管外籍人士占人口比例超过80%，但卡塔尔人在观察到的心脏骤停总数中占20%。改善结局有重大机会，包括基于社区的心肺复苏和除颤培训。
