Nielsen Christian Gantzel, Folke Fredrik, Andelius Linn, Hansen Carolina Malta, Væggemose Ulla, Christensen Erika Frischknecht, Torp-Pedersen Christian, Ersbøll Annette Kjær, Gregers Mads Christian Tofte
Copenhagen Emergency Medical Services, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Front Cardiovasc Med. 2022 Nov 4;9:1030843. doi: 10.3389/fcvm.2022.1030843. eCollection 2022.
The primary aim was to investigate the association between alarm acceptance compared to no-acceptance by volunteer responders, bystander intervention, and survival in out-of-hospital cardiac arrest.
This retrospective observational study included all suspected out-of-hospital cardiac arrests (OHCAs) with activation of volunteer responders in the Capital Region of Denmark (1 November 2018 to 14 May 2019), the Central Denmark Region (1 November 2018 to 31 December 2020), and the Northern Denmark Region (14 February 2020 to 31 December 2020). All OHCAs unwitnessed by Emergency Medical Services (EMS) were analyzed on the basis on alarm acceptance and arrival before EMS. The primary outcomes were bystander cardio-pulmonary resuscitation (CPR), bystander defibrillation and secondary outcome was 30-day survival. A questionnaire sent to all volunteer responders was used with respect to their arrival status.
We identified 1,877 OHCAs with volunteer responder activation eligible for inclusion and 1,725 (91.9%) of these had at least one volunteer responder accepting the alarm (accepted). Of these, 1,355 (79%) reported arrival status whereof 883 (65%) arrived before EMS. When volunteer responders accepted the alarm and arrived before EMS, we found increased proportions and adjusted odds ratio for bystander CPR {94 vs. 83%, 4.31 [95% CI (2.43-7.67)] and bystander defibrillation [13 vs. 9%, 3.16 (1.60-6.25)]} compared to cases where no volunteer responders accepted the alarm.
We observed a fourfold increased odds ratio for bystander CPR and a threefold increased odds ratio for bystander defibrillation when volunteer responders accepted the alarm and arrived before EMS.
主要目的是调查志愿急救人员接受警报与不接受警报、旁观者干预及院外心脏骤停患者生存率之间的关联。
这项回顾性观察性研究纳入了丹麦首都地区（2018年11月1日至2019年5月14日）、丹麦中部地区（2018年11月1日至2020年12月31日）以及丹麦北部地区（2020年2月14日至2020年12月31日）所有激活了志愿急救人员的疑似院外心脏骤停（OHCA）病例。所有未被紧急医疗服务（EMS）目击的院外心脏骤停病例均根据警报接受情况和在EMS之前到达的情况进行分析。主要结局是旁观者心肺复苏（CPR）、旁观者除颤，次要结局是30天生存率。就其到达状态向所有志愿急救人员发送了一份问卷。
我们确定了1877例激活了志愿急救人员且符合纳入标准的院外心脏骤停病例，其中1725例（91.9%）至少有一名志愿急救人员接受了警报（接受组）。在这些病例中，1355例（79%）报告了到达状态，其中883例（65%）在EMS之前到达。当志愿急救人员接受警报并在EMS之前到达时，与没有志愿急救人员接受警报的病例相比，我们发现旁观者心肺复苏的比例增加且调整后的优势比升高{94%对83%，4.31[95%置信区间（2.43 - 7.67）]}，旁观者除颤的比例也增加且调整后的优势比升高[13%对9%，3.16（1.60 - 6.25）]。
我们观察到，当志愿急救人员接受警报并在EMS之前到达时，旁观者心肺复苏的优势比增加了四倍，旁观者除颤的优势比增加了三倍。
