Emergency Department, Bach Mai Hospital, 78 Giai Phong Road, Dong Da District, Hanoi, 100000, Viet Nam.
Department of Nutrition and Food Safety, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam.
Bull World Health Organ. 2021 Jan 1;99(1):50-61. doi: 10.2471/BLT.20.269837. Epub 2020 Oct 28.
To investigate factors associated with survival after out-of-hospital cardiac arrest in Viet Nam.
We did a multicentre prospective observational study of people (> 18 years) presenting with out-of-hospital cardiac arrest (not caused by trauma) to three tertiary hospitals in Viet Nam from February 2014 to December 2018. We collected data on characteristics, management and outcomes of patients with out-of-hospital cardiac arrest and compared these data by type of transportation to hospital and survival to hospital admission. We assessed factors associated with survival to admission to and discharge from hospital using logistic regression analysis.
Of 590 eligible people with out-of-hospital cardiac arrest, 440 (74.6%) were male and the mean age was 56.1 years (standard deviation: 17.2). Only 24.2% (143/590) of these people survived to hospital admission and 14.1% (83/590) survived to hospital discharge. Most cardiac arrests (67.8%; 400/590) occurred at home, 79.4% (444/559) were witnessed by bystanders and 22.3% (124/555) were given cardiopulmonary resuscitation by a bystander. Only 8.6% (51/590) of the people were taken to hospital by the emergency medical services and 32.2% (49/152) received pre-hospital defibrillation. Pre-hospital defibrillation (odds ratio, OR: 3.90; 95% confidence interval, CI: 1.54-9.90) and return of spontaneous circulation in the emergency department (OR: 2.89; 95% CI: 1.03-8.12) were associated with survival to hospital admission. Hypothermia therapy during post-resuscitation care was associated with survival to discharge (OR: 5.44; 95% CI: 2.33-12.74).
Improvements are needed in the emergency medical services in Viet Nam such as increasing bystander cardiopulmonary resuscitation and public access defibrillation, and improving ambulance and post-resuscitation care.
调查越南院外心脏骤停后生存相关因素。
我们对 2014 年 2 月至 2018 年 12 月期间越南三家三级医院收治的院外心脏骤停（非创伤性）患者（>18 岁）进行了一项多中心前瞻性观察研究。我们收集了患者的特征、管理和结局数据，并根据到医院的交通方式和生存至入院情况对这些数据进行了比较。我们使用逻辑回归分析评估了与入院和出院生存相关的因素。
590 名符合条件的院外心脏骤停患者中，440 名（74.6%）为男性，平均年龄为 56.1 岁（标准差：17.2）。这些人中只有 24.2%（143/590）生存至入院，14.1%（83/590）生存至出院。大多数心脏骤停（67.8%；400/590）发生在家庭中，79.4%（444/559）由旁观者目击，22.3%（124/555）由旁观者进行心肺复苏。只有 8.6%（51/590）的人由紧急医疗服务送往医院，32.2%（49/152）在院前接受除颤。院前除颤（比值比，OR：3.90；95%置信区间，CI：1.54-9.90）和急诊科自主循环恢复（OR：2.89；95%CI：1.03-8.12）与生存至入院相关。复苏后治疗期间的低温治疗与出院生存相关（OR：5.44；95%CI：2.33-12.74）。
越南的紧急医疗服务需要改进，例如增加旁观者心肺复苏和公共除颤，以及改进救护车和复苏后护理。
