Institute of Medicine, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Eur Heart J. 2022 Dec 7;43(46):4817-4829. doi: 10.1093/eurheartj/ehac414.
Trends in characteristics, management, and survival in out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA) were studied in the Swedish Cardiopulmonary Resuscitation Registry (SCRR).
The SCRR was used to study 106 296 cases of OHCA (1990-2020) and 30 032 cases of IHCA (2004-20) in whom resuscitation was attempted. In OHCA, survival increased from 5.7% in 1990 to 10.1% in 2011 and remained unchanged thereafter. Odds ratios [ORs, 95% confidence interval (CI)] for survival in 2017-20 vs. 1990-93 were 2.17 (1.93-2.43) overall, 2.36 (2.07-2.71) for men, and 1.67 (1.34-2.10) for women. Survival increased for all aetiologies, except trauma, suffocation, and drowning. OR for cardiac aetiology in 2017-20 vs. 1990-93 was 0.45 (0.42-0.48). Bystander cardiopulmonary resuscitation increased from 30.9% to 82.2%. Shockable rhythm decreased from 39.5% in 1990 to 17.4% in 2020. Use of targeted temperature management decreased from 42.1% (2010) to 18.2% (2020). In IHCA, OR for survival in 2017-20 vs. 2004-07 was 1.18 (1.06-1.31), showing a non-linear trend with probability of survival increasing by 46.6% during 2011-20. Myocardial ischaemia or infarction as aetiology decreased during 2004-20 from 67.4% to 28.3% [OR 0.30 (0.27-0.34)]. Shockable rhythm decreased from 37.4% to 23.0% [OR 0.57 (0.51-0.64)]. Approximately 90% of survivors (IHCA and OHCA) had no or mild neurological sequelae.
Survival increased 2.2-fold in OHCA during 1990-2020 but without any improvement in the final decade, and 1.2-fold in IHCA during 2004-20, with rapid improvement the last decade. Cardiac aetiology and shockable rhythms were halved. Neurological outcome has not improved.
研究了瑞典心肺复苏登记处（SCRR）中院外心脏骤停（OHCA）和院内心脏骤停（IHCA）的特征、治疗和生存趋势。
该研究使用 SCRR 分析了 106296 例 OHCA（1990-2020 年）和 30032 例 IHCA（2004-20 年）患者，这些患者都尝试了复苏。在 OHCA 中，存活率从 1990 年的 5.7%上升到 2011 年的 10.1%，此后保持不变。2017-20 年与 1990-93 年相比，存活的优势比（OR，95%置信区间[CI]）为 2.17（1.93-2.43），男性为 2.36（2.07-2.71），女性为 1.67（1.34-2.10）。除创伤、窒息和溺水外，所有病因的存活率均有所上升。2017-20 年与 1990-93 年相比，心脏病因的 OR 为 0.45（0.42-0.48）。旁观者心肺复苏从 30.9%增加到 82.2%。可除颤节律从 1990 年的 39.5%下降到 2020 年的 17.4%。目标温度管理的使用率从 42.1%（2010 年）下降到 18.2%（2020 年）。在 IHCA 中，2017-20 年与 2004-07 年相比，存活的 OR 为 1.18（1.06-1.31），呈非线性趋势，2011-20 年期间存活概率增加了 46.6%。心肌缺血或梗死作为病因在 2004-20 年间从 67.4%下降到 28.3%[OR 0.30（0.27-0.34）]。可除颤节律从 37.4%下降到 23.0%[OR 0.57（0.51-0.64）]。大约 90%的幸存者（IHCA 和 OHCA）没有或仅有轻微的神经后遗症。
1990-2020 年期间，OHCA 患者的存活率提高了 2.2 倍，但在过去十年中没有任何改善，2004-20 年期间 IHCA 患者的存活率提高了 1.2 倍，最后十年迅速提高。心脏病因和可除颤节律减少了一半。神经预后没有改善。
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