Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK; Division of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UK.
Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea.
Lancet. 2018 Mar 10;391(10124):970-979. doi: 10.1016/S0140-6736(18)30472-0.
Out-of-hospital cardiac arrest (OHCA) is a leading cause of global mortality. Regional variations in reporting frameworks and survival mean the exact burden of OHCA to public health is unknown. Nevertheless, overall prognosis and neurological outcome are relatively poor following OHCA and have remained almost static for the past three decades. In this Series paper, we explore the aetiology of OHCA. Coronary artery disease remains the predominant cause, but there is a diverse range of other potential cardiac and non-cardiac causes to be aware of. Additionally, we describe how investigators and key stakeholders in resuscitation science have formulated specific Utstein data element domains in an attempt to standardise the definitions and outcomes reported in OHCA research so that management pathways can be improved. Finally, we identify the predictors of survival after OHCA and what primary and secondary prevention strategies can be instigated to mitigate the devastating sequelae of this growing public health issue.
院外心脏骤停 (OHCA) 是全球死亡率的主要原因。报告框架和生存率的区域差异意味着 OHCA 对公共卫生的实际负担尚不清楚。尽管如此,OHCA 后整体预后和神经结局仍然相对较差,在过去三十年中几乎没有变化。在本系列论文中,我们探讨了 OHCA 的病因。冠心病仍然是主要原因,但也有一系列其他潜在的心脏和非心脏原因需要注意。此外,我们描述了复苏科学的研究人员和主要利益相关者如何制定特定的 Utstein 数据元素领域,试图标准化 OHCA 研究中报告的定义和结果,以便改进管理途径。最后,我们确定了 OHCA 后生存的预测因素,以及可以启动哪些一级和二级预防策略来减轻这一日益严重的公共卫生问题的破坏性后果。