Litwin P E, Eisenberg M S, Hallstrom A P, Cummins R O
Ann Emerg Med. 1987 Jul;16(7):787-91. doi: 10.1016/s0196-0644(87)80576-0.
Survival from cardiac arrest is higher when the collapse occurs outside the home. Of 781 patients collapsing at home, 101 (13%) survived to hospital discharge. This compared with 66 survivors among 248 (27%) patients arresting outside the home (P less than .001). Patients collapsing outside the home were younger and more frequently were men. Cardiac arrests outside the home were more often witnessed, more likely to have bystander CPR, less often preceded by symptoms, and the collapsing rhythm was more frequently ventricular fibrillation. Mean time to CPR was shorter. Multivariate logistic regression showed that the effect of location on survival was still statistically significant, although diminished, after adjusting for the above variables (P less than .01). We speculate that comorbidity, underlying etiology, and activity level may explain the remaining difference. Because 76% of arrests occur in the home, efforts to increase the frequency of bystander-CPR through targeted and dispatcher-assisted CPR programs are warranted.
在家外发生心脏骤停时的存活率更高。在781名在家中发生心脏骤停的患者中，101名（13%）存活至出院。相比之下，在248名（27%）在家外发生心脏骤停的患者中有66名存活（P小于0.001）。在家外发生心脏骤停的患者更年轻，男性更为常见。在家外发生的心脏骤停更常被目击，更有可能有旁观者进行心肺复苏，症状出现前的情况较少见，且心脏骤停时的心律更常为心室颤动。心肺复苏的平均时间较短。多因素逻辑回归分析显示，在对上述变量进行校正后，尽管影响有所减弱，但地点对存活率的影响仍具有统计学意义（P小于0.01）。我们推测合并症、潜在病因和活动水平可能解释了剩余的差异。由于76%的心脏骤停发生在家中，因此有必要通过有针对性的和调度员辅助的心肺复苏计划来努力提高旁观者心肺复苏的频率。
