Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia.
Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Western Australia, Australia; Emergency and Trauma Centre, The Alfred, Melbourne, Victoria, Australia.
Resuscitation. 2018 May;126:49-57. doi: 10.1016/j.resuscitation.2018.02.029. Epub 2018 Mar 2.
The aim of this study was to investigate regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest (OHCA) in Australia and New Zealand.
This was a population-based cohort study of OHCA using data from the Aus-ROC Australian and New Zealand OHCA Epistry over the period of 01 January 2015-31 December 2015. Seven ambulance services contributed data to the Epistry with a capture population of 19.8 million people. All OHCA attended by ambulance, regardless of aetiology or patient age, were included.
In 2015, there were 19,722 OHCA cases recorded in the Aus-ROC Epistry with an overall crude incidence of 102.5 cases per 100,000 population (range: 51.0-107.7 per 100,000 population). Of all OHCA cases attended by EMS (excluding EMS-witnessed cases), bystander CPR was performed in 41% of cases (range: 36%-50%). Resuscitation was attempted (by EMS) in 48% of cases (range: 40%-68%). The crude incidence for attempted resuscitation cases was 47.6 per 100,000 population (range: 34.7-54.1 per 100,000 population). Of cases with attempted resuscitation, 28% survived the event (range: 21%-36%) and 12% survived to hospital discharge or 30 days (range: 9%-17%; data provided by five ambulance services).
In the first results of the Aus-ROC Australian and New Zealand OHCA Epistry, significant regional variation in the incidence, characteristics and outcomes was observed. Understanding the system-level and public health drivers of this variation will assist in optimisation of the chain of survival provided to OHCA patients with the aim of improving outcomes.
本研究旨在调查澳大利亚和新西兰院外心脏骤停（OHCA）的特征、发生率和结局的地域差异。
这是一项基于人群的 OHCA 队列研究，使用了 2015 年 1 月 1 日至 2015 年 12 月 31 日期间 Aus-ROC 澳大利亚和新西兰 OHCA 登记处的数据。有 7 个救护机构向登记处提供数据，覆盖人群为 1980 万人。所有由救护车救治的 OHCA，无论病因或患者年龄如何，均被纳入研究。
2015 年，Aus-ROC 登记处共记录 19722 例 OHCA，总粗发生率为每 10 万人 102.5 例（范围：每 10 万人 51.0-107.7 例）。在所有由 EMS 救治的 OHCA 中（不包括 EMS 目击病例），旁观者心肺复苏术在 41%的病例中实施（范围：36%-50%）。48%的病例尝试了复苏（由 EMS 进行）（范围：40%-68%）。尝试复苏的病例粗发生率为每 10 万人 47.6 例（范围：每 10 万人 34.7-54.1 例）。在尝试复苏的病例中，28%的患者存活（范围：21%-36%），12%的患者存活至出院或 30 天（范围：9%-17%；由 5 个救护机构提供数据）。
在 Aus-ROC 澳大利亚和新西兰 OHCA 登记处的首批结果中，观察到发病率、特征和结局存在显著的地域差异。了解这种差异的系统水平和公共卫生驱动因素，将有助于优化提供给 OHCA 患者的生存链，以提高其结局。
