2020年与2019年日本院外心脏骤停按病因划分的生存率。
Survival following an out-of-hospital cardiac arrest in Japan in 2020 versus 2019 according to the cause.
作者信息
Hosomi Sanae, Zha Ling, Kiyohara Kosuke, Kitamura Tetsuhisa, Irisawa Taro, Ogura Hiroshi, Oda Jun
机构信息
Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine Suita Japan.
Division of Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine Osaka University Suita Japan.
出版信息
Acute Med Surg. 2022 Aug 27;9(1):e777. doi: 10.1002/ams2.777. eCollection 2022 Jan-Dec.
AIM
The coronavirus disease (COVID-19) pandemic has led to an increase in out-of-hospital cardiac arrests (OHCAs) and mortality. However, there has been no reports in Japan using nationwide registry data. We compared survival among patients with OHCAs and detailed information on the cause during the COVID-19 pandemic (2020), and during the pre-pandemic period (2019).
METHODS
Using a Japanese population-based retrospective cohort study design, we analyzed registry data on 39,324 and 39,170 patients with OHCAs in 2019 and 2020, respectively. We compared patient outcomes in 2019 and 2020 using univariable and multivariable logistic regression analyses.
RESULTS
The proportion of OHCAs of cardiac origin increased significantly from 61.6% in 2019 to 62.7% in 2020 ( = 0.001). The use of bystander CPR (6.9% versus 5.7%, < 0.001) and publicaccess automated external defibrillator pads (3.7% versus 3.0%, < 0.001) decreased significantly from 2019 to 2020. The 1-month survival for OHCA of cardiac origin (12.1% versus 10.7%; adjusted odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87-1.00), asphyxia (10.9% versus 8.8%; adjusted OR 0.80, 95% CI 0.70-0.92), and external causes (adjusted OR 0.66; 95% CI 0.46-0.96), also decreased significantly from 2019 to 2020.
CONCLUSIONS
In Japan, the 1-month survival after OHCA of cardiac origin, or due to asphyxia or external causes, decreased significantly during the COVID-19 pandemic period.
目的
冠状病毒病（COVID-19）大流行导致院外心脏骤停（OHCA）及死亡率上升。然而，日本尚无使用全国登记数据的相关报告。我们比较了COVID-19大流行期间（2020年）和大流行前时期（2019年）OHCA患者的生存率以及病因的详细信息。
方法
采用基于日本人群的回顾性队列研究设计，我们分别分析了2019年和2020年39324例及39170例OHCA患者的登记数据。我们使用单变量和多变量逻辑回归分析比较了2019年和2020年的患者结局。
结果
心脏源性OHCA的比例从2019年的61.6%显著增加至2020年的62.7%（P = 0.001）。从2019年到2020年，旁观者心肺复苏术的使用（6.9%对5.7%，P < 0.001）和公共场所自动体外除颤器电极片的使用（3.7%对3.0%，P < 0.001）显著减少。心脏源性OHCA的1个月生存率（12.1%对10.7%；调整优势比[OR]0.93，95%置信区间[CI]0.87 - 1.00）、窒息（10.9%对8.8%；调整OR 0.80，95% CI 0.70 - 0.92）以及外部原因导致的情况（调整OR 0.66；95% CI 0.46 - 0.96）从2019年到2020年也显著下降。
结论
在日本，COVID-19大流行期间，心脏源性、窒息性或外部原因导致的OHCA后的1个月生存率显著下降。
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