新型冠状病毒肺炎大流行对日本大阪市院外心脏骤停时旁观者干预、紧急医疗服务活动及患者预后的影响。
Influence of COVID-19 pandemic on bystander interventions, emergency medical service activities, and patient outcomes in out-of-hospital cardiac arrest in Osaka City, Japan.
作者信息
Nishiyama Chika, Kiyohara Kosuke, Iwami Taku, Hayashida Sumito, Kiguchi Takeyuki, Matsuyama Tasuku, Katayama Yusuke, Shimazu Takeshi, Kitamura Tetsuhisa
机构信息
Department of Critical Care Nursing, Graduate School of Medicine, Kyoto University, Japan.
Department of Food Science, Otsuma Women's University, Japan.
出版信息
Resusc Plus. 2021 Mar;5:100088. doi: 10.1016/j.resplu.2021.100088. Epub 2021 Jan 29.
BACKGROUND
The coronavirus disease (COVID-19) pandemic may have negatively affected bystander interventions, emergency medical service (EMS) personnel activities, and patient outcomes after out-of-hospital cardiac arrest (OHCA). This study assessed bystander interventions, EMS activities, and patient outcomes during the COVID-19 pandemic era and compared them with those during the non-COVID-19 pandemic era in Osaka City, Japan, where public-access automated external defibrillators (AEDs) are well established.
METHODS
We conducted this population-based cohort study that included all cases with non-traumatic OHCA treated by EMS personnel and excluded cases with no resuscitation attempt, traumatic cases, cases occurring in healthcare facilities, or cases witnessed by EMS personnel. Data were compared between the COVID-19 pandemic period (February 1, 2020 to July 31, 2020) and the non-COVID-19 pandemic period (February 1, 2019 to July 31, 2019).
RESULTS
During the study periods, 1687 patients were eligible for analyses (COVID-19: n = 825; non-COVID-19: n = 862). Patients with OHCA during the COVID-19 pandemic period were significantly less likely to receive bystander cardiopulmonary resuscitation (CPR) (COVID-19: 33.0%; non-COVID-19: 41.3%; p < 0.001) and public-access AED pad application (COVID-19: 2.9%; non-COVID-19: 6.1%; p = 0.002) compared with patients during the non-COVID-19 pandemic period. There were no significant differences in 1-month survival with favorable neurological outcomes between the two periods (COVID-19: 4.6%; non-COVID-19: 6.1%; p = 0.196).
CONCLUSION
The COVID-19 pandemic period did not affect patient outcomes after OHCA but changed bystander behaviors in Osaka City, Japan.
背景
冠状病毒病（COVID-19）大流行可能对旁观者干预、紧急医疗服务（EMS）人员的活动以及院外心脏骤停（OHCA）后的患者结局产生了负面影响。本研究评估了COVID-19大流行时期的旁观者干预、EMS活动和患者结局，并将其与日本大阪市非COVID-19大流行时期的情况进行比较，大阪市的公共自动体外除颤器（AED）配备完善。
方法
我们开展了这项基于人群的队列研究，纳入了所有由EMS人员治疗的非创伤性OHCA病例，并排除了未进行复苏尝试的病例、创伤性病例、在医疗机构发生的病例或由EMS人员目击的病例。对COVID-19大流行期间（2020年2月1日至2020年7月31日）和非COVID-19大流行期间（2019年2月1日至2019年7月31日）的数据进行了比较。
结果
在研究期间，1687例患者符合分析条件（COVID-19：n = 825；非COVID-19：n = 862）。与非COVID-19大流行期间的患者相比，COVID-19大流行期间发生OHCA的患者接受旁观者心肺复苏（CPR）的可能性显著降低（COVID-19：33.0%；非COVID-19：41.3%；p < 0.001），使用公共AED电极片的可能性也显著降低（COVID-19：2.9%；非COVID-19：6.1%；p = 0.002）。两个时期之间1个月时具有良好神经功能结局的生存率无显著差异（COVID-19：4.6%；非COVID-19：6.1%；p = 0.196）。
结论
COVID-19大流行时期并未影响OHCA后的患者结局，但改变了日本大阪市旁观者的行为。
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