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在 COVID-19 大流行期间,由急救医疗服务团队治疗的院外心脏骤停:一项回顾性队列研究。

Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study.

机构信息

Białystok Oncology Center, Białystok, Poland.

Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.

出版信息

Cardiol J. 2021;28(1):15-22. doi: 10.5603/CJ.a2020.0135. Epub 2020 Nov 3.

Abstract

BACKGROUND

Out-of-hospital cardiac arrest (OHCA) is a challenge for medical personnel, especially in the current COVID-19 pandemic, where medical personnel should perform resuscitation wearing full personal protective equipment. This study aims were to assess the characteristics and outcomes of adults who suffered an OHCA in the COVID-19 pandemic treated by emergency medical service (EMS) teams.

METHODS

All EMS-attended OHCA adults over than 18 years in the Polish EMS registry were analyzed. The retrospective EMS database was conducted. EMS interventions performed between March 1, and April 30, 2020 were retrospectively screened.

RESULTS

In the study period EMS operated 527 times for OHCA cases. The average age of patients with OHCA was 67.8 years. Statistically significantly more frequently men were involved (64.3%). 298 (56.6%) of all OHCA patients had resuscitation attempted by EMS providers. Among resuscitated patients, 73.8% were cardiac etiology. 9.4% of patients had return of spontaneous circulation, 27.2% of patients were admitted to hospital with ongoing chest compression. In the case of 63.4% cardiopulmonary resuscitation was ineffective and death was determined.

CONCLUSIONS

The present study found that OHCA incidence rate in the Masovian population (central region of Poland) in March-April 2020 period was 12.2/100,000 adult inhabitants. Return of spontaneous circulation in EMS was observed only in 9.4% of resuscitated patients. The presence of shockable rhythms was associated with better prognosis. The prehospital mortality, even though it was high, did not differ from those reported by other studies.

摘要

背景

院外心脏骤停(OHCA)对医务人员来说是一个挑战,尤其是在当前 COVID-19 大流行期间,医务人员在进行心肺复苏时应穿戴全套个人防护装备。本研究旨在评估在 COVID-19 大流行期间由急救医疗服务(EMS)团队治疗的成人 OHCA 的特征和结局。

方法

分析了波兰 EMS 注册中心所有 18 岁以上接受 EMS 治疗的 OHCA 成年患者。进行了回顾性 EMS 数据库研究。对 2020 年 3 月 1 日至 4 月 30 日期间进行的 EMS 干预措施进行了回顾性筛查。

结果

在研究期间,EMS 对 527 次 OHCA 病例进行了操作。OHCA 患者的平均年龄为 67.8 岁。男性患者比例显著更高(64.3%)。所有 OHCA 患者中,有 298 例(56.6%)由 EMS 提供者尝试进行复苏。在接受复苏的患者中,有 73.8%的病因是心脏原因。有 9.4%的患者出现自主循环恢复,27.2%的患者在持续胸外按压的情况下被收入医院。在 63.4%的情况下,心肺复苏无效,确定死亡。

结论

本研究发现,2020 年 3 月至 4 月期间,波兰马佐夫舍地区(波兰中部地区)的 OHCA 发病率为 12.2/10 万成年居民。仅在 9.4%的复苏患者中观察到自主循环恢复。可除颤节律的存在与更好的预后相关。尽管院前死亡率很高,但与其他研究报告的死亡率没有差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdd5/8105074/37a5c489b389/cardj-28-1-15f1.jpg

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