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阿拉贡山区救援中院前急救期间心脏事件的流行病学

Epidemiology of Cardiac Events During Prehospital Care in Mountain Rescues Conducted in Aragón.

作者信息

Martínez-Caballero Carmen M, Sierra Quintana Eva

机构信息

Emergency Service of Castilla y León, Spain.

Emergency Service of Aragón, Spain.

出版信息

Wilderness Environ Med. 2019 Mar;30(1):22-27. doi: 10.1016/j.wem.2018.10.009. Epub 2019 Feb 6.

Abstract

INTRODUCTION

Cardiac events are one of the leading causes of death in the Spanish population. Given the increase in the nontraumatic medical conditions found in mountain rescues, the objective of this study was to report on the heart conditions of patients rescued in the mountains of Aragón in the Spanish Pyrenees.

METHODS

We conducted a retrospective observational study based on data collected from patients' medical histories for rescues undertaken in from 2010 to 2016 (at altitudes between 500 m [1640 ft] and 3404 m [11,168 ft]).

RESULTS

Of the 2079 individuals rescued from 2010 to 2016, 34 (2%) were diagnosed with heart conditions, accounting for 21% of all nontraumatic medical conditions. The data showed a statistically significant increase in the age of the rescued patients with heart conditions (55±15 y) and those with acute coronary syndrome/sudden death (60±8 y). Eighty-five percent of the rescued patients with heart conditions were men, 62% were rescued above 2000 m (6500 ft), 42% had acute coronary syndrome (of whom 56% had inferior infarction), and 35% died suddenly.

CONCLUSIONS

Aragón mountain rescues show an increase in patient age in recent years. The most common medical case among rescued individuals with heart conditions was a hiker over the age of 50 y with cardiovascular risk factors, inferior infarction, and occurrence at an altitude above 2000 m. Based on our observations, appropriate training should be undertaken, especially by older hikers, who may also benefit from cardiac screening, and rescue vehicles/personnel and mountain huts should be equipped with semiautomatic external defibrillators.

摘要

引言

心脏事件是西班牙人口的主要死因之一。鉴于山地救援中发现的非创伤性医疗状况有所增加,本研究的目的是报告在西班牙比利牛斯山脉阿拉贡山区获救患者的心脏状况。

方法

我们基于2010年至2016年(海拔500米[1640英尺]至3404米[11,168英尺])救援时收集的患者病史数据进行了一项回顾性观察研究。

结果

在2010年至2016年获救的2079人中,34人(2%)被诊断患有心脏疾病,占所有非创伤性医疗状况的21%。数据显示,患有心脏疾病的获救患者(55±15岁)以及患有急性冠状动脉综合征/猝死的患者(60±8岁)年龄在统计学上有显著增加。患有心脏疾病的获救患者中85%为男性,62%在海拔2000米(6500英尺)以上获救,42%患有急性冠状动脉综合征(其中56%为下壁梗死),35%突然死亡。

结论

阿拉贡山区救援显示近年来患者年龄有所增加。在患有心脏疾病的获救人员中,最常见的医疗病例是一名50岁以上有心血管危险因素、下壁梗死且在海拔2000米以上发病的徒步旅行者。根据我们的观察,应进行适当培训,尤其是对老年徒步旅行者,他们可能也会从心脏筛查中受益,并且救援车辆/人员和山间小屋应配备半自动体外除颤器。

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