Emergency Department, University Hospital of Nancy, France.
Emergency Department, University Hospital of Nancy, France; INSERM, Clinical Investigation Center - Unit 1433, University Hospital of Nancy, Vandoeuvre les, Nancy, France; INSERM U1116, Université de Lorraine, Nancy, France.
Resuscitation. 2019 Nov;144:91-98. doi: 10.1016/j.resuscitation.2019.08.032. Epub 2019 Sep 6.
Cardiac arrest (CA) was considered irreversible until 1960, when basic cardiopulmonary resuscitation (CPR) was defined. CPR guidelines include early recognition of CA, rapid and effective CPR, effective defibrillation strategies and organized post-resuscitation to ensure a strengthening of the survival chain. Bystanders are the key to extremely early management, which is associated with the early medical care provided by EMS. This study aims to assess the prognosis of a bystander's cardiac CPR when it is initiated by the Dispatch Centre (DC).
We included patients in 3 groups according to who initiated the CPR. The groups were matched according to multiple propensity partition methods. We presented our results in terms of 30-day survival and neurological prognosis.
85,634 patients were included. Statistical study focused on 18,185 patients once the exclusion criteria were applied. 12,743 (70.1%) are men and the average age is 70.1 years. Survival at D30 was 5.11% in the absence of CPR, 8.86% with bystander initiation and 7.35% with DC initiation (p < 0.001). Survival at D30 with favourable neurologic prognosis (CPC 1-2) was 76.30%, 83.69% and 82.82%, respectively. Our results show a 3.75% increase in the chance of survival at D30 if CPR was initiated by bystanders compared to patients for whom CPR was not initiated, a 2.25% increase in survival in the group that received from CPR initiated by the DC compared to the group that did not receive CPR.
Bystander CPR initiated by the DC represents a suitable option following out-of-hospital cardiac arrest.
直到 1960 年，当基本的心肺复苏（CPR）被定义时，心脏骤停（CA）被认为是不可逆的。CPR 指南包括早期识别 CA、快速有效的 CPR、有效的除颤策略和有组织的复苏后护理，以确保加强生存链。旁观者是实现极早期管理的关键，这与 EMS 提供的早期医疗护理有关。本研究旨在评估调度中心（DC）启动旁观者心脏 CPR 的预后。
我们根据谁启动了 CPR 将患者分为 3 组。通过多倾向分区方法对这些组进行了匹配。我们根据 30 天生存率和神经预后结果呈现研究结果。
共纳入 85634 例患者。排除标准应用后，对 18185 例患者进行了统计学研究。12743 例（70.1%）为男性，平均年龄为 70.1 岁。在没有 CPR 的情况下，D30 的生存率为 5.11%，有旁观者启动的 CPR 的生存率为 8.86%，有 DC 启动的 CPR 的生存率为 7.35%（p<0.001）。D30 时具有良好神经预后（CPC 1-2）的生存率分别为 76.30%、83.69%和 82.82%。我们的结果表明，如果旁观者启动 CPR，与未启动 CPR 的患者相比，D30 的生存率增加了 3.75%，与未接受 CPR 的患者相比，DC 启动的 CPR 使 D30 的生存率增加了 2.25%。
院外心脏骤停后，DC 启动旁观者 CPR 是一种合适的选择。
