Chang Ikwan, Kwak Young Ho, Shin Sang Do, Ro Young Sun, Kim Do Kyun
Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Laboratory of Emergency Medical Services, Seoul National University Hospital, Biomedical Research Institute, Republic of Korea.
Resuscitation. 2017 Feb;111:26-33. doi: 10.1016/j.resuscitation.2016.11.007. Epub 2016 Nov 25.
This study evaluated the associations between the provision of bystander cardiopulmonary resuscitation (BCPR) and both the relationship of bystanders with paediatric out-of-hospital cardiac arrest (OHCA) victims and the community educational level.
This observational study was conducted using the Korean national OHCA registry of paediatric OHCAs (<19years old) between 2012 and 2014. The main factor was the relationship between the bystander and the OHCA victim. The primary endpoint was the provision of BCPR. The association between BCPR provision and community educational level was also examined. Multivariable logistic regression and interaction analyses were performed to determine whether community educational level affected BCPR provision.
Among the 1477 enrolled patients, 725 (49.1%) received BCPR. Family members provided BCPR in 458 (57.4%) cases. The adjusted odds ratios and corresponding 95% confidence intervals (AORs, 95% CIs) for the provision of BCPR by family members or first responders compared with strangers were 1.75 (1.31-2.34) and 8.90 (5.00-15.84). The AORs for BCPR provision in communities with the middle and lowest educational levels compared with the highest were 0.70 (0.53-0.92) and 1.11 (0.79-1.55). The interaction analysis showed that the AORs of family members or first responders providing BCPR compared with strangers were 1.32 (0.79-2.19) and 5.90 (1.98-17.63), 1.98 (1.31-2.98) and 10.88 (4.20-28.16), and 1.87 (1.18-2.96) and 9.89 (3.88-25.21) in communities with the lowest, middle and highest educational levels, respectively.
In paediatric OHCA cases, family members were more likely than strangers to perform BCPR except in communities with the lowest educational level.
本研究评估了旁观者实施心肺复苏术（BCPR）与旁观者和儿科院外心脏骤停（OHCA）受害者的关系以及社区教育水平之间的关联。
本观察性研究使用了2012年至2014年韩国全国儿科OHCA（<19岁）登记系统。主要因素是旁观者与OHCA受害者之间的关系。主要终点是BCPR的实施情况。还研究了BCPR实施与社区教育水平之间的关联。进行多变量逻辑回归和交互分析以确定社区教育水平是否影响BCPR的实施。
在1477名登记患者中，725名（49.1%）接受了BCPR。家庭成员在458例（57.4%）中实施了BCPR。与陌生人相比，家庭成员或第一反应者实施BCPR的调整后比值比及相应的95%置信区间（AORs，95% CIs）分别为1.75（1.31 - 2.34）和8.90（5.00 - 15.84）。与教育水平最高的社区相比，教育水平中等和最低的社区中BCPR实施的AORs分别为0.70（0.53 - 0.92）和1.11（0.79 - 1.55）。交互分析显示，与陌生人相比，教育水平最低、中等和最高的社区中家庭成员或第一反应者实施BCPR的AORs分别为1.32（0.79 - 2.19）和5.90（1.98 - 17.63）、1.98（1.31 - 2.98）和10.88（4.20 - 28.16）、1.87（1.18 - 2.96）和9.89（3.88 - 25.21）。
在儿科OHCA病例中，除了教育水平最低的社区外，家庭成员比陌生人更有可能实施BCPR。
