Tanner Richard, Masterson Siobhan, Galvin Joseph, Wright Peter, Hennelly David, Murphy Andrew, Bury Gerard, O'Donnell Cathal, Deasy Conor
Cardiology, Cork University Hospital Group, Cork, Ireland
Discipline of General Practice, University College Galway, Galway, Galway, Ireland.
Postgrad Med J. 2021 May;97(1147):280-285. doi: 10.1136/postgradmedj-2020-137597. Epub 2020 May 5.
Out-of-hospital cardiac arrests (OHCA) in the young population have only been examined in a limited number of regional studies. Hence, we sought to describe OHCA characteristics and predictors of survival to hospital discharge for the young Irish population.
An observational analysis of the national Irish OHCA register for all OHCAs aged ≤35 years between January 2012 and December 2017 was performed. The young population was categorised into three age groups: ≤1 year, 1-15 years and 16-35 years. Multivariable logistic regression was used to determine the independent predictors of survival to hospital discharge.
A total of 1295 OHCAs aged ≤35 years (26.9% female, median age 25 (IQR 17-31)) had resuscitation attempted. OHCAs in those aged ≥16 years (n=1005) were more likely to happen outside the home (38.5% vs 22.8%, p<0.001) and be of non-medical aetiology (59% vs 27.6%, p<0.001) compared with those aged <16 years (n=290). Asphyxiation, trauma and drug overdoses accounted for over 90% of the non-medical OHCAs for those 16-35 years. Overall survival to hospital discharge for the cohort was 5.1%; survival was non-significantly higher for those aged 16-35 years compared with those aged 1-15 years (6.0%, vs 2.8% p=0.93). Independent predictors of survival to hospital discharge included bystander witnessed OHCA, a shockable initial rhythm and a bystander defibrillation attempt.
The high prevalence of non-medical OHCAs and the OHCA location need to be considered when developing OHCA care pathways and preventative strategies to reduce the burden of OHCAs in the young population.
仅在少数区域研究中对年轻人群院外心脏骤停（OHCA）进行了考察。因此，我们试图描述爱尔兰年轻人群OHCA的特征以及存活至出院的预测因素。
对2012年1月至2017年12月期间爱尔兰全国OHCA登记册中所有年龄≤35岁的OHCA进行了观察性分析。年轻人群被分为三个年龄组：≤1岁、1 - 15岁和16 - 35岁。采用多变量逻辑回归来确定存活至出院的独立预测因素。
共有1295例年龄≤35岁的OHCA（26.9%为女性，中位年龄25岁（四分位间距17 - 31岁））接受了复苏尝试。与年龄<16岁（n = 290）的人群相比，年龄≥16岁（n = 1005）的OHCA更有可能发生在家外（38.5%对22.8%，p<0.001）且病因非医疗性（59%对27.6%，p<0.001）。窒息、创伤和药物过量占16 - 35岁人群非医疗性OHCA的90%以上。该队列总体存活至出院率为5.1%；16 - 35岁人群的存活率与1 - 15岁人群相比无显著差异（6.0%对2.8%，p = 0.93）。存活至出院的独立预测因素包括旁观者目击的OHCA、可电击的初始心律以及旁观者进行除颤尝试。
在制定OHCA护理路径和预防策略以减轻年轻人群OHCA负担时，需要考虑非医疗性OHCA的高患病率和OHCA发生地点。
