Hosomi Sanae, Kitamura Tetsuhisa, Sobue Tomotaka, Zha Ling, Kiyohara Kosuke, Matsuyama Tasuku, Oda Jun
Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamada-oka, Suita 565-0871, Japan.
Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Japan.
J Clin Med. 2022 Jun 20;11(12):3564. doi: 10.3390/jcm11123564.
The effects of epinephrine administration timing on patients with out-of-hospital cardiac arrest (OHCA) following traffic collisions are unknown. We analyzed the 2013-2019 All-Japan Utstein Registry data of 2024 such patients aged ≥18 years who were resuscitated by emergency medical service (EMS) personnel or bystanders and then transported to medical institutions. Time from 119 call to epinephrine administration was classified into quartiles: Q1 (6-21 min), Q2 (22-26 min), Q3 (27-34 min), and Q4 (35-60 min). Multivariable logistic regression analysis was used to assess the effects of epinephrine administration timing on one-month survival after OHCA. Overall, the one-month survival rates were 3.2% (15/466) in Q1, 1.1% (5/472) in Q2, 1.9% (11/577) in Q3, and 0.2% (1/509) in Q4. Additionally, the one-month survival rate decreased significantly in the Q4 group (adjusted odds ratio, 0.07; 95% confidence interval, 0.01-0.57) compared with the Q1 group, and the probability of one-month survival decreased as the time from the EMS call to epinephrine administration increased (-value for trend = 0.009). Only four patients (0.9% [4/466]) with the earliest epinephrine administration showed a good neurological outcome.
肾上腺素给药时机对交通碰撞后院外心脏骤停（OHCA）患者的影响尚不清楚。我们分析了2013 - 2019年全日本Utstein登记处的数据，这些数据来自2024例年龄≥18岁、由紧急医疗服务（EMS）人员或旁观者进行复苏后转运至医疗机构的此类患者。从拨打119到给予肾上腺素的时间被分为四分位数：Q1（6 - 21分钟）、Q2（22 - 26分钟）、Q3（27 - 34分钟）和Q4（35 - 60分钟）。采用多变量逻辑回归分析来评估肾上腺素给药时机对OHCA后1个月生存率的影响。总体而言，Q1组的1个月生存率为3.2%（15/466），Q2组为1.1%（5/472），Q3组为1.9%（11/577），Q4组为0.2%（1/509）。此外，与Q1组相比，Q4组的1个月生存率显著降低（调整后的优势比为0.07；95%置信区间为0.01 - 0.57），并且从EMS呼叫到给予肾上腺素的时间越长，1个月生存的概率越低（趋势检验P值 = 0.009）。最早给予肾上腺素的仅4例患者（0.9% [4/466]）显示出良好的神经学预后。
