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2019年冠状病毒病大流行期间,延迟转运对心脏骤停患者临床结局的影响。

Effect of delayed transport on clinical outcomes among patients with cardiac arrest during the coronavirus disease 2019 pandemic.

作者信息

Chung Hosub, Namgung Myeong, Lee Dong Hoon, Choi Yoon Hee, Bae Sung Jin

机构信息

Department of Emergency Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, 1071, Anyangcheon-ro, Yangcheon-gu, Seoul, Republic of Korea; Department of Emergency Medicine, Graduate school of Medicine, Seoul, Chung-Ang University, 102, Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea.

Department of emergency medicine, College of Medicine, Seoul, Chung-Ang University, Emergency medicine, Chung-Ang university hospital, 102, Heukseok-ro, Dongjak-gu, Seoul, Republic of Korea.

出版信息

Australas Emerg Care. 2022 Sep;25(3):241-246. doi: 10.1016/j.auec.2021.11.006. Epub 2021 Nov 30.

Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has prompted many changes. Revised cardiopulmonary resuscitation (CPR) recommendations were issued including increased requirement for personal protective equipment (PPE) during CPR and isolation rooms. We hypothesized that these changes might have affected transport times and distance. Accordingly, we investigated any differences in transport time and distance and their effect on patient neurologic outcomes at hospital discharge.

METHODS

This retrospective study was conducted among patients who experienced cardiopulmonary arrest and were admitted to an emergency department during specific periods - pre-COVID-19 (January 1 to December 31, 2019) and COVID-19 (March 1, 2020, to February 28, 2021).

RESULT

The mean transport distance was 3.5 ± 2.1 km and 3.7 ± 2.3 km during the pre-COVID-19 and COVID-19 periods, respectively (p = 0.664). The mean total transport time was 30.3 ± 6.9 min and 35.6 ± 9.3 min during the pre-COVID-19 and COVID-19 periods, respectively (p < 0.001). The mean activation time was 1.5 ± 2.2 min and 2.9 ± 4.5 min during the pre-COVID-19 and COVID-19 periods, respectively (p = 0.003). The mean transport time was 9.3 ± 3.5 min and 11.5 ± 6 min during the pre-COVID-19 and COVID-19 periods, respectively (p = 0.001).

CONCLUSION

Total transport time, including activation time for out-of-hospital cardiac arrest patients, increased owing to increased PPE requirements. However, there was no significant difference in the neurological outcome at hospital discharge.

摘要

背景

2019年冠状病毒病(COVID-19)大流行引发了许多变化。发布了修订后的心肺复苏(CPR)建议,包括在心肺复苏期间和隔离病房对个人防护装备(PPE)的需求增加。我们推测这些变化可能影响了转运时间和距离。因此,我们调查了转运时间和距离的任何差异及其对出院时患者神经学结局的影响。

方法

本回顾性研究在特定时期(COVID-19之前,即2019年1月1日至12月31日;以及COVID-19期间,即2020年3月1日至2021年2月28日)经历心脏骤停并入住急诊科的患者中进行。

结果

在COVID-19之前和COVID-19期间,平均转运距离分别为3.5±2.1千米和3.7±2.3千米(p = 0.664)。在COVID-19之前和COVID-19期间,平均总转运时间分别为30.3±6.9分钟和35.6±9.3分钟(p < 0.001)。在COVID-19之前和COVID-19期间,平均启动时间分别为1.5±2.2分钟和2.9±4.5分钟(p = 0.003)。在COVID-19之前和COVID-19期间,平均转运时间分别为9.3±3.5分钟和11.5±6分钟(p = 0.001)。

结论

由于对个人防护装备的要求增加,院外心脏骤停患者的总转运时间(包括启动时间)有所增加。然而,出院时的神经学结局没有显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0edd/8629739/9c5e451b8db3/gr1_lrg.jpg

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