University of Chicago Biological Sciences Division, Chicago, Illinois, USA
Division of Emergency Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa.
BMJ Open. 2022 Mar 25;12(3):e055008. doi: 10.1136/bmjopen-2021-055008.
Out-of-hospital cardiac arrest (OHCA) is well studied in high-income countries, and research has encouraged the implementation of policy to increase survival rates. On the other hand, comprehensive research on OHCA in Africa is sparse, despite the higher incidence of risk factors. In this vein, structural barriers to OHCA care in Africa must be fully recognised and understood before similar improvements in outcome may be made. The aim of this study was to describe and summarise the body of literature related to OHCA in Africa.
Using an a priori developed search strategy, electronic searches were performed in Medline via Pubmed, Web of Science, Scopus and Google Scholar databases to identify articles published in English between 2000 and 2020 relevant to OHCA in Africa. Titles, abstract and full text were reviewed by two reviewers, with discrepancies handled by an independent reviewer. A summary of the main themes contained in the literature was developed using descriptive analysis on eligible articles.
A total of 1200 articles were identified. In the screening process, 785 articles were excluded based on title, and a further 127 were excluded following abstract review. During full-text review to determine eligibility, 80 articles were excluded and one was added following references review. A total of 19 articles met the inclusion criteria. During analysis, the following three themes were found: epidemiology and underlying causes for OHCA, first aid training and bystander action, and Emergency Medical Services (EMS) resuscitation and training.
In order to begin addressing OHCA in Africa, representative research with standardised reporting that complies to data standards is required to understand the full, context-specific picture. Policies and research may then target underlying conditions, improvements in bystander and EMS training, and system improvements that are contextually relevant and ultimately result in better outcomes for OHCA victims.
在高收入国家，院外心脏骤停（OHCA）的研究较为深入，研究鼓励实施相关政策以提高存活率。另一方面，尽管非洲的危险因素发生率较高，但对 OHCA 的全面研究却很少。因此，在可能取得类似结果之前，必须充分认识和理解非洲 OHCA 护理的结构性障碍。本研究旨在描述和总结与非洲 OHCA 相关的文献。
使用预先制定的搜索策略，通过 Medline 中的 Pubmed、Web of Science、Scopus 和 Google Scholar 数据库进行电子检索，以确定 2000 年至 2020 年间发表的与非洲 OHCA 相关的英文文章。两名评审员审查标题、摘要和全文，有分歧的地方由独立评审员处理。对符合条件的文章进行描述性分析，总结文献中的主要主题。
共确定了 1200 篇文章。在筛选过程中，根据标题排除了 785 篇文章，在摘要审查后又排除了 127 篇文章。在全文审查以确定合格性时，排除了 80 篇文章，并在参考文献审查后添加了 1 篇文章。共有 19 篇文章符合纳入标准。在分析过程中，发现了以下三个主题：OHCA 的流行病学和根本原因、急救培训和旁观者行动、以及紧急医疗服务（EMS）复苏和培训。
为了开始解决非洲的 OHCA，需要进行具有代表性的研究，并采用符合数据标准的标准报告，以了解全面的、具体背景的情况。政策和研究可以针对根本原因、旁观者和 EMS 培训的改进以及与上下文相关并最终为 OHCA 患者带来更好结果的系统改进。
