Fan K L, Leung L P, Siu Y C
Accident and Emergency Department, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
Hong Kong Med J. 2017 Feb;23(1):48-53. doi: 10.12809/hkmj166046. Epub 2017 Jan 6.
Out-of-hospital cardiac arrest is a global health care problem. Like other cities in the world, Hong Kong faces the impact of such events. This study is the first territory-wide investigation of the epidemiology and outcomes of out-of-hospital cardiac arrest in Hong Kong. It is hoped that the findings can improve survival of patients with cardiac arrest.
This study was a retrospective analysis of the prospectively collected data on out-of-hospital cardiac arrest managed by the emergency medical service from 1 August 2012 to 31 July 2013. The characteristics of patients and cardiac arrests, timeliness of emergency medical service attendance, and survival rates were reported with descriptive statistics. Predictors of 30-day survival were evaluated with logistic regression.
A total of 5154 cases of out-of-hospital cardiac arrest were analysed. The median age of patients was 80 years. Most arrests occurred at the patient's home. Ventricular fibrillation or ventricular tachycardia was identified in 8.7% of patients. The median time taken for the emergency services to reach the patient was 9 minutes. The median time to first defibrillation was 12 minutes. Of note, 2.3% of patients were alive at 30 days or survived to hospital discharge; 1.5% had a good neurological outcome. Location of arrest, initial electrocardiogram rhythm, and time to first defibrillation were independent predictors of survival at 30 days.
The survival rate of out-of-hospital cardiac arrest patients in Hong Kong is low. Territory-wide public access defibrillation programme and cardiopulmonary resuscitation training may help improve survival.
院外心脏骤停是一个全球性的医疗保健问题。与世界上其他城市一样，香港也面临此类事件的影响。本研究是香港首次对院外心脏骤停的流行病学和结局进行的全地区调查。希望研究结果能够提高心脏骤停患者的生存率。
本研究对2012年8月1日至2013年7月31日期间由紧急医疗服务处理的院外心脏骤停的前瞻性收集数据进行回顾性分析。用描述性统计报告患者和心脏骤停的特征、紧急医疗服务出勤的及时性以及生存率。用逻辑回归评估30天生存率的预测因素。
共分析了5154例院外心脏骤停病例。患者的中位年龄为80岁。大多数心脏骤停发生在患者家中。8.7%的患者被确定为室颤或室速。紧急服务到达患者的中位时间为9分钟。首次除颤的中位时间为12分钟。值得注意的是，2.3%的患者在30天时存活或存活至出院；1.5%有良好的神经学结局。心脏骤停的位置、初始心电图节律和首次除颤时间是30天生存率的独立预测因素。
香港院外心脏骤停患者的生存率较低。全地区公众可及的除颤计划和心肺复苏培训可能有助于提高生存率。
