Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, WA, Australia.
Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, WA, Australia; Discipline of Emergency Medicine, University of Western Australia, Crawley, WA, Australia.
Resuscitation. 2017 Jul;116:60-65. doi: 10.1016/j.resuscitation.2017.05.005. Epub 2017 May 2.
To investigate the relationship between chest compression fraction (CCF) and survival outcomes in OHCA, including whether the relationship varied based upon downtime from onset of arrest to provision of cardiopulmonary resuscitation (CPR) by emergency medical services (EMS).
Data from resuscitations performed by St John Ambulance Western Australia (SJA-WA) paramedics between July 2014 and June 2016 was captured using the Q-CPR feedback device. Logistic regression analysis was used to study the relationship between CCF and return of spontaneous circulation (ROSC). Various lengths of Q-CPR data were used ranging from the first 3min to all available episode data. Cases were subsequently divided into groups based upon downtime; ≤15min, >15min and unknown. Univariate and multivariable logistic regression analyses were performed in each group.
There were 341 cases eligible for inclusion. CCF >80% was significantly associated with decreased odds of ROSC compared to CCF≤80% (aOR: 0.49, 95%CI: 0.28-0.87). This relationship remained significant whether the first 3min of data was used, the first 5min or all available episode data. Among the group with a downtime >15min, CCF was significantly lower for those who achieved ROSC compared to those who did not (mean (SD): 73.01 (12.99)% vs. 83.05 (9.38)% p=0.002). The adjusted odds ratio for achieving ROSC in this group was significantly less with CCF>80% compared to CCF≤80% (aOR: 0.06, 95%CI: 0.01-0.38).
We demonstrated an inverse relationship between CCF and ROSC that varied depending upon the time from arrest to provision of EMS-CPR.
探讨胸外按压分数（CCF）与 OHCA 生存结果之间的关系，包括这种关系是否因从发病到紧急医疗服务（EMS）提供心肺复苏（CPR）的停机时间而有所不同。
使用 Q-CPR 反馈设备捕获了 2014 年 7 月至 2016 年 6 月期间由圣约翰急救西澳分部（SJA-WA）护理人员进行的复苏数据。Logistic 回归分析用于研究 CCF 与自主循环恢复（ROSC）之间的关系。使用了从最初 3 分钟到所有可用发作数据的各种长度的 Q-CPR 数据。随后根据停机时间将病例分为≤15 分钟、>15 分钟和未知组。在每个组中进行单变量和多变量逻辑回归分析。
共有 341 例符合纳入标准。与 CCF≤80%相比，CCF>80%与 ROSC 的几率降低显著相关（比值比：0.49，95%置信区间：0.28-0.87）。这种关系在使用最初 3 分钟数据、最初 5 分钟或所有可用发作数据时仍然显著。在停机时间>15 分钟的组中，与未实现 ROSC 的患者相比，实现 ROSC 的患者 CCF 显著降低（平均值（标准差）：73.01（12.99）%比 83.05（9.38）%，p=0.002）。在该组中，与 CCF≤80%相比，CCF>80%实现 ROSC 的调整比值比显著降低（比值比：0.06，95%置信区间：0.01-0.38）。
我们证明了 CCF 与 ROSC 之间呈反比关系，这种关系因从发病到 EMS-CPR 的提供时间而有所不同。
