Hung Shih-Chang, Mou Ching-Yi, Hung Hung-Chang, Lai Shih-Wei, Chen Chun-Chih, Lin Jui-Wen, Wang Ssu-Hung, Chen Chung-Kuang, Cheng Kai-Chun
Department of Emergency Medicine, Nantou Hospital, Nantou, Taiwan.
Department of Health Care Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
Aust J Rural Health. 2017 Dec;25(6):354-361. doi: 10.1111/ajr.12341. Epub 2016 Dec 23.
Out-of-hospital cardiac arrest (OHCA) studies are usually conducted at metropolitan medical centres. Because rural studies are rare, our study aimed to assess non-traumatic OHCA prevalence and resuscitation outcomes in rural Taiwan.
A retrospective observational study.
All seven designated community hospital emergency departments (ED) in Nantou County, Taiwan.
All OHCA patients from May 2011 to March 2013.
Any return of spontaneous circulation (ROSC) and survival for ED discharge.
In the 23-month period, 850 OHCA cases were reported; 741 (87.2%) were non-traumatic. The overall ROSC achievement rate was 19.7%, with 16.4% case survival for ED discharge. Logistic regression identified that arrest in public (OR: 2.62, 95% CI: 1.19-5.78), witness when collapsed (OR: 2.14, 95% CI: 1.28-3.60), and cardiopulmonary resuscitation (CPR) by bystander (OR: 2.09, 95% CI: 1.02-4.26) might increase the likelihood of any ROSC; arrest in public (OR: 2.68, 95% CI: 1.10-6.50), witnessed collapse (OR: 2.26, 95% CI: 1.24-4.09) and CPR by bystander (OR: 2.79, 95% CI: 1.28-6.05) might also increase the likelihood of survival. For non-traumatic OHCA patients conveyed to EDs via emergency medical service system (EMS), a shorter response time (OR: 1.09, 95% CI: 1.01-1.18) and travelling time (OR: 1.04, 95% CI: 1.00-1.09) might also increase the chance of survival.
Compared to previous data from metropolitan areas, ROSC achievement rate was lower in rural Taiwan. Witness presence, response and travelling times affect ROSC achievement in non-traumatic OHCA patients in rural Taiwan.
院外心脏骤停（OHCA）研究通常在大城市医疗中心进行。由于农村地区的研究较少，我们的研究旨在评估台湾农村地区非创伤性OHCA的患病率和复苏结果。
一项回顾性观察研究。
台湾南投县所有七家指定的社区医院急诊科（ED）。
2011年5月至2013年3月期间所有OHCA患者。
任何自主循环恢复（ROSC）情况以及出院时存活情况。
在这23个月期间，共报告了850例OHCA病例；741例（87.2%）为非创伤性。总体ROSC成功率为19.7%，出院时病例存活率为16.4%。逻辑回归分析表明，在公共场所发生心脏骤停（比值比：2.62，95%置信区间：1.19 - 5.78）、倒地时有目击者（比值比：2.14，95%置信区间：1.28 - 3.60）以及有旁观者进行心肺复苏（CPR）（比值比：2.09，95%置信区间：1.02 - 4.26）可能会增加出现任何ROSC的可能性；在公共场所发生心脏骤停（比值比：2.68，95%置信区间：1.10 - 6.50）、有目击者倒地（比值比：2.26，95%置信区间：1.24 - 4.09）以及有旁观者进行心肺复苏（比值比：2.79，95%置信区间：1.28 - 6.05）也可能会增加存活的可能性。对于通过紧急医疗服务系统（EMS）转运至急诊科的非创伤性OHCA患者，较短的反应时间（比值比：1.09，95%置信区间：1.01 - 1.18）和转运时间（比值比：1.04，95%置信区间：1.00 - 1.09）也可能会增加存活几率。
与大城市地区之前的数据相比，台湾农村地区的ROSC成功率较低。目击者在场情况、反应时间和转运时间会影响台湾农村地区非创伤性OHCA患者的ROSC成功率。
