Department of Science and Research, Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302, Yunnan, China.
Department of Emergency Medicine, Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, 650302, Yunnan, China.
Eur J Med Res. 2023 Jan 4;28(1):8. doi: 10.1186/s40001-022-00955-x.
This study aimed to assess the survival outcomes among patients with out-of-hospital cardiac arrest (CA) who received cardiopulmonary resuscitation (CPR) in China.
Relevant studies, published between January 1, 2010 and September 5, 2022, were retrieved from databases, including EMBASE, PubMed, Cochrane Library, the China Biology Medicine disk, China National Knowledge Infrastructure, and Wanfang databases. We included clinical studies in which all patients were diagnosed with CA and underwent out-of-hospital CPR, and the outcome variables were at least one of the following: return of spontaneous circulation (ROSC), survival to admission, survival to hospital discharge, 1-month survival, achieved good neurological outcomes, and 1-year survival. Two investigators independently extracted the study data and assessed its quality using a modified Newcastle-Ottawa Scale tool. The data were pooled using random-effects models.
Of the 3620 identified studies, 49 (63,378 patients) were included in the meta-analysis. The pooled ROSC rate was 9.0% (95% confidence interval [CI] 7.5-10.5%, I = 97%), the pooled survival to admission rate was 5.0% (95% CI 2.7-8.0%, I = 98%), and the pooled survival to discharge rate was 1.8% (95% CI 1.2-2.5%, I = 95%). Additionally, the ROSC rate of patients with bystander CPR was significantly higher than that of those without bystander CPR, and the pooled odds ratio (OR) was 7.92 (95% CI 4.32-14.53, I = 85%). The ROSC rate of participants who started CPR within 5 min was significantly higher than that of those who started CPR after 5 min, and the pooled OR was 5.92 (95% CI 1.92-18.26, I = 85%). The ROSC rate of participants with defibrillation was significantly higher than that of those without defibrillation, and the pooled OR was 8.52 (95% CI 3.72-19.52, I = 77%).
The survival outcomes of out-of-hospital CPR in China are far below the world average. Therefore, the policy of providing automated external defibrillators (AEDs) in public places and strengthening CPR training for healthcare providers and public personnel should be encouraged and disseminated nationwide. Trial registration This study was registered in PROSPERO (CRD42022326165) on 29 April 2022.
本研究旨在评估在中国接受心肺复苏（CPR）的院外心脏骤停（CA）患者的生存结局。
检索了 2010 年 1 月 1 日至 2022 年 9 月 5 日期间来自 EMBASE、PubMed、Cochrane 图书馆、中国生物医学文献数据库、中国知网和万方数据库的相关研究。我们纳入了所有患者均诊断为 CA 并接受院外 CPR 的临床研究，并且结局变量至少包括以下之一：自主循环恢复（ROSC）、入院存活、出院存活、1 个月存活、实现良好神经结局和 1 年存活。两名研究者独立提取研究数据，并使用改良的 Newcastle-Ottawa 量表工具评估其质量。使用随机效应模型对数据进行汇总。
在 3620 项确定的研究中，有 49 项（63378 名患者）纳入荟萃分析。ROSC 率为 9.0%（95%置信区间 7.5-10.5%，I=97%），入院存活率为 5.0%（95%置信区间 2.7-8.0%，I=98%），出院存活率为 1.8%（95%置信区间 1.2-2.5%，I=95%）。此外，有旁观者 CPR 的患者的 ROSC 率明显高于没有旁观者 CPR 的患者，汇总优势比（OR）为 7.92（95%置信区间 4.32-14.53，I=85%）。CPR 开始在 5 分钟内的患者的 ROSC 率明显高于 5 分钟后开始 CPR 的患者，汇总 OR 为 5.92（95%置信区间 1.92-18.26，I=85%）。进行除颤的患者的 ROSC 率明显高于未进行除颤的患者，汇总 OR 为 8.52（95%置信区间 3.72-19.52，I=77%）。
中国院外 CPR 的生存结局远低于世界平均水平。因此，应鼓励并在全国范围内推广在公共场所提供自动体外除颤器（AED）和加强医疗保健提供者和公众人员的 CPR 培训的政策。
文献来源：《中国院外心脏骤停心肺复苏后生存结局的 Meta 分析》，中华急诊医学杂志，2023 年 32 卷 03 期。
