Department of Emergency Medicine, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, Republic of Korea.
Department of Emergency Medicine, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu, Republic of Korea.
Am J Emerg Med. 2020 Sep;38(9):1760-1766. doi: 10.1016/j.ajem.2020.05.108. Epub 2020 Jun 2.
This study intended to find out how association between response time interval (RTI) and good neurological outcome is affected by bystander CPR. We hypothesized that bystander CPR will ensure positive effect in relationship between RTI and clinical outcome.
A retrospective, observational study was made with Pan-Asian Resuscitation Outcome Study data from January 2009 to December 2016. Six cities from four Asian countries were selected. EMS-treated, non-traumatic witnessed out-of-hospital cardiac arrest (OHCA) cases were included. General demographic data, prehospital cardiac arrest details and clinical outcome were collected and analyzed according to whether bystander CPR was performed. Good neurological outcome and survival discharge were primary and secondary outcomes.
A total of 13,245 OHCA cases were analyzed. Median EMS response time intervals were 6 min, regardless of bystander CPR. Dividing into RTI time range by 3 min, good neurological outcome and survival discharge were only significant in 3 to 6 minutes group (adjusted odds ratio [AOR] 1.42, 1.17-1.73 95% confidence interval [CI] and AOR 1.31, 1.15-1.51 95% CI) in non-bystander CPR group but in bystander CPR group significant RTI time range was 3 to 9 min (AOR 2.02, 1.82, 1.62-2.52, 1.48-2.25 95% CI for primary, AOR 1.66, 1.43, 1.41-1.96, 1.22-1.67 95% CI for secondary).
As response time interval increased, slower deterioration of good neurological outcome and survival discharge was shown in cardiac arrest patients with bystander CPR performed. If bystander CPR is provided, RTI time range showing significant neurological outcome and survival improvement seems to be relatively lengthened.
本研究旨在探讨反应时间间隔（RTI）与良好神经功能结局之间的关联受旁观者心肺复苏（CPR）的影响。我们假设旁观者 CPR 将确保 RTI 与临床结局之间的关系产生积极影响。
对 2009 年 1 月至 2016 年 12 月期间的泛亚复苏结果研究数据进行回顾性、观察性研究。从四个亚洲国家中选择了六个城市。纳入 EMS 治疗、非创伤性目击的院外心脏骤停（OHCA）病例。收集并分析一般人口统计学数据、院前心脏骤停详细信息和临床结局，根据是否进行旁观者 CPR 进行分类。良好的神经功能结局和存活出院是主要和次要结局。
共分析了 13245 例 OHCA 病例。无论旁观者 CPR 情况如何，EMS 反应时间间隔中位数均为 6 分钟。将 RTI 时间范围分为 3 分钟，非旁观者 CPR 组中仅在 3 至 6 分钟组中具有显著的良好神经功能结局和存活出院（调整比值比[OR]1.42，95%置信区间[CI]1.17-1.73 和调整 OR 1.31，95%CI1.15-1.51），但在旁观者 CPR 组中，显著的 RTI 时间范围为 3 至 9 分钟（主要结局的调整 OR 2.02，1.82，1.62-2.52，1.48-2.25 95%CI，次要结局的调整 OR 1.66，1.43，1.41-1.96，1.22-1.67 95%CI）。
在进行旁观者 CPR 的心脏骤停患者中，随着反应时间间隔的增加，良好神经功能结局和存活出院的恶化速度较慢。如果提供旁观者 CPR，则显示神经功能结局和存活改善具有显著意义的 RTI 时间范围似乎相对延长。
