Department of Research and Evaluation, Ambulance Victoria, 375 Manningham Road, Doncaster Victoria 3108, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Level 6, 99 Commercial Road, Melbourne Victoria 3004, Australia.
Eur Heart J. 2017 Jun 1;38(21):1666-1673. doi: 10.1093/eurheartj/ehw500.
Increased public awareness of the warning signs of a heart attack and the importance of early medical intervention may help to prevent premature deaths from out-of-hospital cardiac arrest (OHCA). We sought to investigate the impact of the Heart Foundation's public awareness campaigns on the monthly incidence of, and deaths from, OHCA in Melbourne, Australia.
Between July 2005 and June 2015, we included registry data for 25 060 OHCA of presumed cardiac aetiology. Time series models with distributed lags were used to explore the effect of campaign activity on OHCA outcomes. A sensitivity analysis involving segmented regression of the pre-intervention, intervention, and post-intervention time segments was also performed. The mean monthly incidence of, and deaths from, OHCA was 207 and 189 events respectively. After adjustment for temporal trends, campaign activity was associated with a 6.0% [95% confidence interval (CI): 2.8-9.0%; P < 0.001] reduction in the monthly incidence of OHCA, or 11.7% (95% CI: 7.7-15.5%, P < 0.001) with the addition of residual effects in two additional lag months. Similarly, the rate of deaths from OHCA reduced by 6.4% (95% CI: 2.8-10.0%; P = 0.001) during months with campaign activity. Campaign activity had a greater effect in males and patients aged ≥65 years, and reduced the incidence of OHCA in unwitnessed and initial non-shockable arrests. In the segmented regression analysis, the intervention period was associated with a 15.2% (95% CI: 9.2-20.9%; P < 0.001) reduction in the mean monthly incidence and a 16.6% (95% CI: 9.9-22.7%; P < 0.001) reduction in deaths from OHCA.
A comprehensive mass media campaign targeting the community's awareness of heart attack symptoms was associated with a substantial reduction in the incidence of OHCA and associated deaths.
提高公众对心脏病发作警告信号的认识以及对早期医学干预的重视，可能有助于预防院外心脏骤停（OHCA）导致的过早死亡。我们旨在调查澳大利亚墨尔本心脏基金会公众意识宣传活动对 OHCA 每月发病率和死亡率的影响。
在 2005 年 7 月至 2015 年 6 月期间，我们纳入了 25060 例疑似心源性 OHCA 的登记数据。使用分布滞后时间序列模型来探讨活动对 OHCA 结果的影响。还进行了涉及干预前、干预中和干预后时间段的分段回归的敏感性分析。OHCA 的平均每月发病率和死亡率分别为 207 例和 189 例。经时间趋势调整后，活动与 OHCA 每月发病率降低 6.0%（95%置信区间：2.8-9.0%；P<0.001），在另外两个滞后月中加入残留效应后，降低 11.7%（95%置信区间：7.7-15.5%，P<0.001）。同样，OHCA 死亡率的比率在有活动的月份降低了 6.4%（95%置信区间：2.8-10.0%；P=0.001）。活动在男性和年龄≥65 岁的患者中效果更大，并降低了无人见证和初始非电击除颤骤停的 OHCA 发病率。在分段回归分析中，干预期与 OHCA 每月平均发病率降低 15.2%（95%置信区间：9.2-20.9%；P<0.001）和 OHCA 死亡率降低 16.6%（95%置信区间：9.9-22.7%；P<0.001）相关。
针对社区对心脏病发作症状的认识的全面大众媒体宣传活动与 OHCA 发病率和相关死亡率的大幅降低相关。
