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心脏安全社区的心脏骤停存活率。

Sudden cardiac arrest survival in HEARTSafe communities.

机构信息

Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA.

Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA.

出版信息

Resuscitation. 2020 Jan 1;146:13-18. doi: 10.1016/j.resuscitation.2019.10.029. Epub 2019 Nov 6.

Abstract

BACKGROUND

The HEARTSafe Communities program promotes community efforts to improve systems for treating sudden cardiac arrest (SCA). The study hypothesis was that the rates of SCA survival to admission, discharge, and discharge with CPC score 1 or 2 are higher in HEARTSafe-designated communities than non-designated communities in Connecticut, USA. Secondary outcomes included bystander CPR and AED application.

METHODS

The state Office of EMS supplied a list of towns that are HEARTSafe-designated, and dates of designation. The Cardiac Arrest Registry to Enhance Survival provided data for all SCA from 2013 to 2017 in the 70 participating towns. For each SCA, it was determined whether the town was HEARTSafe-designated at the time.

RESULTS

Of 2922 SCA cases, 1569 (54%) occurred in towns that were HEARTSafe-designated. Patients in designated towns were 1.15 times more likely to have AEDs applied by bystanders, and 1.15 times more likely to have CPR started by bystanders, than were patients in non-designated towns, but these differences were not significance (p = 0.66 and 0.28). The likelihood of surviving to admission was 1.33 times higher (p = 0.02) in designated towns. The likelihood of surviving to discharge was 1.33 times higher, and of surviving to discharge with CPC 1 or 2 was 1.4 times higher, but these differences were not significant (p = 0.17 and 0.13).

CONCLUSION

SCA survival rates do not differ between HEARTSafe and non-HEARTSafe communities in Connecticut. SCA patients in HEARTSafe communities are no more likely to receive bystander AED application or bystander CPR.

摘要

背景

HEARTSafe 社区计划旨在促进社区努力改善治疗心脏骤停 (SCA) 的系统。研究假设是,在美国康涅狄格州,与非指定社区相比,指定为 HEARTSafe 的社区中 SCA 存活率到入院、出院和出院时 CPC 评分为 1 或 2 的比例更高。次要结局包括旁观者 CPR 和 AED 的应用。

方法

州紧急医疗服务办公室提供了一份指定为 HEARTSafe 的城镇名单和指定日期。心脏骤停登记处提供了 2013 年至 2017 年 70 个参与城镇所有 SCA 的数据。对于每个 SCA,确定当时城镇是否为 HEARTSafe 指定。

结果

在 2922 例 SCA 中,有 1569 例(54%)发生在指定为 HEARTSafe 的城镇。与非指定城镇相比,指定城镇的患者更有可能被旁观者应用 AED,旁观者更有可能开始 CPR,但其差异无统计学意义(p=0.66 和 0.28)。指定城镇入院存活率提高 1.33 倍(p=0.02)。出院存活率提高 1.33 倍,出院时 CPC 评分为 1 或 2 的存活率提高 1.4 倍,但差异无统计学意义(p=0.17 和 0.13)。

结论

康涅狄格州的 HEARTSafe 和非 HEARTSafe 社区之间 SCA 存活率没有差异。HEARTSafe 社区的 SCA 患者不太可能接受旁观者 AED 应用或旁观者 CPR。

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