Park Song Yi, Lim Daesung, Kim Seong Chun, Ryu Ji Ho, Kim Yong Hwan, Choi Byungho, Kim Sun Hyu
Department of Emergency Medicine, Dong-A University College of Medicine, Dong-A University Hospital, Busan 48114, Korea.
Department of Emergency Medicine, Seoul Medical Center, Seoul 03080, Korea.
J Clin Med. 2022 Jul 21;11(14):4248. doi: 10.3390/jcm11144248.
This retrospective study aimed to compare the survival outcomes of adult out-of-hospital cardiac arrest (OHCA) patients between urban (Busan, Ulsan, Changwon) and rural (Gyeongnam) areas in South Korea and identify modifiable factors in the chain of survival. The primary and secondary outcomes were survival to discharge and modifiable factors in the chain of survival were identified using logistic regression analysis. In total, 1954 patients were analyzed. The survival to discharge rates in the whole region and in urban and rural areas were 6.9%, 8.7% (Busan 8.7%, Ulsan 10.3%, Changwon 7.2%), and 3.4%, respectively. In the urban group, modifiable factors associated with survival to discharge were no advanced airway management (adjusted odds ratio (aOR) 2.065, 95% confidence interval (CI): 1.138-3.747), no mechanical chest compression (aOR 3.932, 95% CI: 2.015-7.674), and an emergency medical service (EMS) transport time of more than 8 min (aOR 3.521, 95% CI: 2.075-5.975). In the rural group, modifiable factors included an EMS scene time of more than 15 min (aOR 0.076, 95% CI: 0.006-0.883) and an EMS transport time of more than 8 min (aOR 4.741, 95% CI: 1.035-21.706). To improve survival outcomes, dedicated resources and attention to EMS practices and transport time in urban areas and EMS scene and transport times in rural areas are needed.
这项回顾性研究旨在比较韩国城市地区（釜山、蔚山、昌原）和农村地区（庆南）成年院外心脏骤停（OHCA）患者的生存结局，并确定生存链中的可改变因素。主要和次要结局分别为出院生存率，通过逻辑回归分析确定生存链中的可改变因素。总共分析了1954例患者。整个地区以及城市和农村地区的出院生存率分别为6.9%、8.7%（釜山8.7%、蔚山10.3%、昌原7.2%）和3.4%。在城市组中，与出院生存相关的可改变因素包括未进行高级气道管理（调整优势比（aOR）2.065，95%置信区间（CI）：1.138 - 3.747）、未进行机械胸外按压（aOR 3.932，95%CI：2.015 - 7.674）以及紧急医疗服务（EMS）转运时间超过8分钟（aOR 3.521，95%CI：2.075 - 5.975）。在农村组中，可改变因素包括EMS现场时间超过15分钟（aOR 0.076，95%CI：0.006 - 0.883）和EMS转运时间超过8分钟（aOR 4.741，95%CI：1.035 - 21.706）。为改善生存结局，需要在城市地区投入专门资源并关注EMS实践和转运时间，在农村地区关注EMS现场和转运时间。
