Lin Yen-Nien, Chang Shih-Sheng, Wang Lee-Min, Chi Hwan-Ting, Ueng Kwo-Chang, Tsai Chin-Feng, Phan Chee-Seong, Lu Li-Hua, Hii Choon-Hoon, Chung Yu-Ting, Chugh Sumeet S, Chen Ming-Fong, Wu Tsu-Juey, Chang Kuan-Cheng
Division of Cardiovascular Medicine, China Medical University, Taichung, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan; Cardiovascular Research Laboratory, China Medical University Hospital, Taichung, Taiwan.
Department of Emergency, Taichung Veterans General Hospital, Taichung, Taiwan.
Mayo Clin Proc. 2017 Mar;92(3):347-359. doi: 10.1016/j.mayocp.2016.10.029.
To identify the incidence and prehospital predictors of ventricular tachycardia/ventricular fibrillation (VT/VF) as the initial arrhythmia in patients with out-of-hospital cardiac arrest (OHCA) in central Taiwan.
The Taichung Sudden Unexpected Death Registry program encompasses the Taichung metropolitan area in central Taiwan, with a population of 2.7 million and 17 destination hospitals for patients with OHCA. We performed a detailed analysis of demographic characteristics, circumstances of cardiac arrest, and emergency medical service records using the Utstein Style.
From May 1, 2013, through April 30, 2014, resuscitation was attempted in 2013 individuals with OHCA, of which 384 were excluded due to trauma and noncardiac etiologies. Of the 1629 patients with presumed cardiogenic OHCA, 7.9% (n=129) had initial shockable rhythm; this proportion increased to 18.8% (61 of 325) in the witnessed arrest subgroup. Male sex (odds ratio [OR], 2.45; 95% CI, 1.46-4.12; P<.001), age younger than 65 years (OR, 2.39, 95% CI, 1.58-3.62; P<.001), public location of arrest (OR, 4.61; 95% CI, 2.86-7.44; P<.001), and witnessed status (OR, 3.98; 95% CI, 2.62-6.05; P<.001) were independent predictors of VT/VF rhythm.
The proportion of patients with OHCA presenting with VT/VF was generally low in this East Asian population. Of the prehospital factors associated with VT/VF, public location of OHCA was the strongest predictor of VT/VF in this population, which may affect planning and deployment of emergency medical services in central Taiwan.
确定台湾中部院外心脏骤停（OHCA）患者中，室性心动过速/心室颤动（VT/VF）作为初始心律失常的发生率及院前预测因素。
台中市意外猝死登记项目覆盖台湾中部的台中市都会区，人口270万，有17家收治OHCA患者的指定医院。我们采用Utstein模式对人口统计学特征、心脏骤停情况及急救医疗服务记录进行了详细分析。
2013年5月1日至2014年4月30日期间，对2013例OHCA患者尝试进行了复苏，其中384例因创伤和非心脏病因被排除。在1629例推测为心源性OHCA的患者中，7.9%（n = 129）初始心律为可电击心律；在目击心脏骤停亚组中，这一比例增至18.8%（325例中的61例）。男性（比值比[OR]，2.45；95%可信区间[CI]，1.46 - 4.12；P <.001）、年龄小于65岁（OR，2.39，95% CI，1.58 - 3.62；P <.001）、心脏骤停发生在公共场所（OR，4.61；95% CI，2.86 - 7.44；P <.001）以及目击状态（OR，3.98；95% CI，2.62 - 6.05；P <.001）是VT/VF心律的独立预测因素。
在这一东亚人群中，以VT/VF作为初始心律的OHCA患者比例总体较低。在与VT/VF相关的院前因素中，OHCA发生在公共场所是该人群中VT/VF的最强预测因素，这可能会影响台湾中部地区急救医疗服务的规划与部署。
