Scquizzato Tommaso, D'Amico Filippo, Rocchi Margherita, Saracino Marco, Stella Federica, Landoni Giovanni, Zangrillo Alberto
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (TS, FDA, MR, MS, GL, AZ); School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (GL, AZ); Emergency Medical Services (SUEM 118), Venice, Italy (FS).
Prehosp Emerg Care. 2021 Sep 14:1-12. doi: 10.1080/10903127.2021.1967535.
COVID-19 pandemic overwhelmed healthcare systems and diverted resources allocated for other conditions. This systematic review and meta-analysis aimed to analyse how the pandemic impacted the system-of-care of out-of-hospital cardiac arrest. We searched PubMed and Embase up to May 31, 2021, for studies comparing out-of-hospital cardiac arrests that occurred during the COVID-19 pandemic versus a non-pandemic period. Survival at hospital discharge or at 30 days was the primary outcome. We included 24 studies for a total of 75,952 patients. Out-of-hospital cardiac arrests during COVID-19 pandemic had lower survival (19 studies; 603/11,666 [5.2%] vs. 1320/17,174 [7.7%]; OR = 0.54; 95% CI, 0.44-0.65; = 0.001) and return of spontaneous circulation (4370/24353 [18%] vs. 7401/34510 [21%]; OR = 0.64; 95% CI, 0.55-0.75; < 0.001) compared with non-pandemic periods. Ambulance response times (10.1 vs 9.0 minutes, MD = 1.01; 95% CI, 0.59-1.42; < 0.001) and non-shockable rhythms (18,242/21,665 [84%] vs. 19,971/24,817 [81%]; OR = 1.27; 95% CI, 1.10-1.46; P < 0.001) increased. Use of supraglottic airways devices increased (2853/7645 [37%] vs. 2043/17521 [12%]; OR = 1.97; 95% CI, 1.42-2.74; < 0.001). The COVID-19 pandemic affected the system-of-care of out-of-hospital cardiac arrest, and patients had worse short-term outcomes compared to pre-pandemic periods. Advanced airway management strategy shifted from endotracheal intubation to supraglottic airway devices.
PROSPERO CRD42021250339.
新冠疫情使医疗系统不堪重负，并转移了分配给其他病症的资源。本系统评价和荟萃分析旨在分析疫情如何影响院外心脏骤停的护理系统。我们检索了截至2021年5月31日的PubMed和Embase数据库，以查找比较新冠疫情期间与非疫情期间发生的院外心脏骤停的研究。出院时或30天的生存率是主要结局。我们纳入了24项研究，共75952例患者。与非疫情期间相比，新冠疫情期间院外心脏骤停的生存率较低（19项研究；603/11666 [5.2%] 对比1320/17174 [7.7%]；OR = 0.54；95% CI，0.44 - 0.65；P = 0.001），自主循环恢复率较低（4370/24353 [18%] 对比7401/34510 [21%]；OR = 0.64；95% CI，0.55 - 0.75；P < 0.001）。救护车响应时间延长（10.1对比9.0分钟，MD = 1.01；95% CI，0.59 - 1.42；P < 0.001），不可电击心律的比例增加（18242/21665 [84%] 对比19971/24817 [81%]；OR = 1.27；95% CI，1.10 - 1.46；P < 0.001）。声门上气道装置的使用增加（2853/7645 [37%] 对比2043/17521 [12%]；OR = 1.97；95% CI，1.42 - 2.74；P < 0.001）。新冠疫情影响了院外心脏骤停的护理系统，与疫情前相比，患者的短期结局更差。高级气道管理策略从气管插管转向声门上气道装置。
PROSPERO CRD42021250339。
