Lim Shir Lynn, Kumar Lekshmi, Saffari Seyed Ehsan, Shahidah Nur, Al-Araji Rabab, Ng Qin Xiang, Ho Andrew Fu Wah, Arulanandam Shalini, Leong Benjamin Sieu-Hon, Liu Nan, Siddiqui Fahad Javaid, McNally Bryan, Ong Marcus Eng Hock
Department of Cardiology, National University Heart Centre, Singapore 119228, Singapore.
Department of Medicine, National University of Singapore, Singapore 119228, Singapore.
J Clin Med. 2022 Sep 1;11(17):5177. doi: 10.3390/jcm11175177.
Variations in the impact of the COVID-19 pandemic on out-of-hospital cardiac arrest (OHCA) have been reported. We aimed to, using population-based registries, compare community response, Emergency Medical Services (EMS) interventions and outcomes of adult, EMS-treated, non-traumatic OHCA in Singapore and metropolitan Atlanta, before and during the pandemic. Associations of OHCA characteristics, pre-hospital interventions and pandemic with survival to hospital discharge were analyzed using logistic regression. There were 2084 cases during the pandemic (17 weeks from the first confirmed COVID-19 case) and 1900 in the pre-pandemic period (corresponding weeks in 2019). Compared to Atlanta, OHCAs in Singapore were older, received more bystander interventions (cardiopulmonary resuscitation (CPR): 65.0% vs. 41.4%; automated external defibrillator application: 28.6% vs. 10.1%), yet had lower survival (5.6% vs. 8.1%). Compared to the pre-pandemic period, OHCAs in Singapore and Atlanta occurred more at home (adjusted odds ratio (aOR) 2.05 and 2.03, respectively) and were transported less to hospitals (aOR 0.59 and 0.36, respectively) during the pandemic. Singapore reported more witnessed OHCAs (aOR 1.96) yet less bystander CPR (aOR 0.81) during pandemic, but not Atlanta (p < 0.05). The impact of COVID-19 on OHCA outcomes did not differ between cities. Changes in OHCA characteristics and management during the pandemic, and differences between Singapore and Atlanta were likely the result of systemic and sociocultural factors.
已有报告称，新冠疫情对院外心脏骤停（OHCA）的影响存在差异。我们旨在利用基于人群的登记系统，比较疫情前和疫情期间新加坡和亚特兰大大都市地区成人非创伤性OHCA经紧急医疗服务（EMS）救治后的社区反应、EMS干预措施及预后情况。采用逻辑回归分析OHCA特征、院前干预措施及疫情与出院存活之间的关联。疫情期间（自首例确诊新冠病例起17周）共2084例病例，疫情前时期（2019年相应周数）有1900例。与亚特兰大相比，新加坡的OHCA患者年龄更大，接受旁观者干预更多（心肺复苏（CPR）：65.0%对41.4%；自动体外除颤器使用：28.6%对10.1%），但存活率较低（5.6%对8.1%）。与疫情前时期相比，新加坡和亚特兰大的OHCA在家中发生的情况更多（调整优势比（aOR）分别为2.05和2.03），疫情期间转运至医院的情况更少（aOR分别为0.59和0.36）。新加坡报告称疫情期间目睹的OHCA更多（aOR 1.96），但旁观者CPR更少（aOR 0.81），而亚特兰大并非如此（p<0.05）。新冠疫情对OHCA预后的影响在不同城市间无差异。疫情期间OHCA特征及管理的变化以及新加坡和亚特兰大之间的差异可能是系统和社会文化因素导致的。
