Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia; Department of Emergency Medical Care, Prince Sultan Military College of Health Sciences, Al-Dhahran, Saudi Arabia.
Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Victoria, Australia; Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia.
Resuscitation. 2019 Nov;144:17-24. doi: 10.1016/j.resuscitation.2019.08.036. Epub 2019 Sep 9.
Little is known about the long-term trends in the incidence and outcomes of drug overdose out-of-hospital cardiac arrests (OHCA).
Between 2000 and 2017, we retrospectively reviewed drug overdose OHCAs from the Victorian Ambulance Cardiac Arrest Registry. Incidence was assessed using linear regression, and the baseline characteristics and survival outcomes were assessed using nonparametric test for trend. Arrest factors associated with survival to hospital discharge were assessed using logistic regression. The 12-month functional recovery and health related quality of life for survivors was summarised using descriptive statistics.
The incidence of emergency medical services (EMS)-attended and EMS-treated cases was 5.8 and 2.0 per 100,000 person-years, respectively, with no significant changes in trend over time. Return of spontaneous circulation increased from 23% to 34% (p for trend = 0.001), event survival increased from 23% to 30% (p for trend = 0.007), and survival to hospital discharge increased from 4% to 13% (p for trend = 0.03). Age, arrest witnessed by bystander or EMS, initial shockable rhythm or pulseless electrical activity, intubation, epinephrine and sodium bicarbonate administration were independently associated with survival. The adjusted-temporal trend for survival was not significant (per year increase; OR 1.02, 95% CI: 0.98, 1.07; p = 0.244). Of the 12-month survivors, 50% of the responders reported good functional recovery, and few reported severe problems with mobility, self-care, daily activity, pain, and anxiety/depression.
Although the incidence of drug overdose OHCA remained unchanged between 2000 and 2017, the rates of survival have significantly improved.
对于院外心脏骤停（OHCA）中药物过量的发生率和结局的长期趋势，人们知之甚少。
在 2000 年至 2017 年期间，我们回顾性地审查了维多利亚救护车心脏骤停登记处的药物过量 OHCA。使用线性回归评估发生率，并使用非参数趋势检验评估基线特征和生存结局。使用逻辑回归评估与生存至出院相关的复苏因素。使用描述性统计总结幸存者 12 个月的功能恢复和健康相关生活质量。
紧急医疗服务（EMS）处理和 EMS 治疗病例的发生率分别为每 100,000 人年 5.8 和 2.0，且趋势无明显变化。自主循环恢复率从 23%增加到 34%（趋势 p 值=0.001），事件存活率从 23%增加到 30%（趋势 p 值=0.007），存活至出院的比例从 4%增加到 13%（趋势 p 值=0.03）。年龄、旁观者或 EMS 见证的复苏、初始可除颤节律或无脉性电活动、插管、肾上腺素和碳酸氢钠的使用与存活率独立相关。生存的调整时间趋势不显著（每年增加；OR 1.02，95%CI：0.98，1.07；p=0.244）。在 12 个月的幸存者中，50%的反应者报告功能恢复良好，少数报告活动、自我护理、日常活动、疼痛、焦虑/抑郁方面存在严重问题。
尽管 2000 年至 2017 年期间药物过量 OHCA 的发生率保持不变，但存活率显著提高。
