Department of Emergency Medicine, Chonnam National University Hospital, Gwang-ju, Republic of Korea.
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Am J Emerg Med. 2018 Aug;36(8):1350-1355. doi: 10.1016/j.ajem.2017.12.040. Epub 2017 Dec 20.
Previous studies on cardiac arrest in mountainous areas were focused on environmental features such as altitude and temperature. However, those are limited to factors affecting the prognosis of patients after cardiac arrest. We analyzed the cardiac arrests in national or provincial parks located in the mountains and determined the factors affecting the prognosis of patients after cardiac arrest.
This study included all emergency medical service (EMS) treated patients over the age of 40 experiencing out-of-hospital cardiac arrests (OHCAs) of presumed cardiac etiology during exercise, between January 2012 and December 2015. The main focus of interest was the location of cardiac arrest occurrence (national mountain parks and provincial parks vs. other sites). The main outcome was survival to discharge and multivariable logistic regression was performed to adjust for possible confounding effects.
A total 1835 patients who suffered a cardiac arrest while exercising were included. From these, 68 patients experienced cardiac arrest in national or provincial parks, and 1767 occurred in other locations. The unadjusted and adjusted ORs (95% CI) for a good cerebral performance scale (CPC) were 0.09 (0.01-0.63) and 0.08(0.01-0.56), survival discharges were 0.13(0.03-0.53) and 0.11 (0.03-0.48).
Cardiac arrests occurring while exercising in the mountainous areas have worse prognosis compared to alternative locations.
先前关于山区心脏骤停的研究主要集中在海拔和温度等环境特征上。然而，这些因素仅限于影响心脏骤停后患者预后的因素。我们分析了位于山区的国家或省级公园内的心脏骤停事件，并确定了影响心脏骤停后患者预后的因素。
本研究纳入了所有年龄在 40 岁以上的在山区因运动而发生院外心脏骤停（OHCA）的患者，这些患者的心脏骤停原因被认为是心源性的。研究的主要关注点是心脏骤停发生地点（国家山地公园和省级公园与其他地点）。主要结局是存活出院，并进行多变量逻辑回归以调整可能的混杂效应。
共有 1835 名因运动而发生心脏骤停的患者被纳入研究。其中 68 名患者在国家或省级公园发生心脏骤停，1767 名患者在其他地点发生心脏骤停。调整前后良好的脑功能预后量表（CPC）的比值比（OR）（95%置信区间）分别为 0.09（0.01-0.63）和 0.08（0.01-0.56），存活率分别为 0.13（0.03-0.53）和 0.11（0.03-0.48）。
与其他地点相比，山区运动时发生的心脏骤停患者预后更差。
