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院外心脏骤停患者接受体外心肺复苏时院前医生在场情况:日本一项多中心、回顾性、全国性观察性研究(JAAM-OHCA注册研究)

Prehospital Physician Presence for Patients With out-of-Hospital Cardiac Arrest Undergoing Extracorporeal Cardiopulmonary Resuscitation: A Multicenter, Retrospective, Nationwide Observational Study in Japan (The JAAM-OHCA registry).

作者信息

Nakajima Satoshi, Matsuyama Tasuku, Watanabe Makoto, Komukai Sho, Kandori Kenji, Okada Asami, Okada Yohei, Kitamura Tetsuhisa, Ohta Bon

机构信息

Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.

Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.

出版信息

Curr Probl Cardiol. 2023 May;48(5):101600. doi: 10.1016/j.cpcardiol.2023.101600. Epub 2023 Jan 18.

Abstract

The effectiveness of the presence of a prehospital physician for patients with out-of-hospital cardiac arrest (OHCA) undergoing extracorporeal cardiopulmonary resuscitation (ECPR) remains unknown. In this multicenter, retrospective, observational study, we enrolled patients aged ≥18 years who developed OHCA and received ECPR. The primary outcome was the 1-month favorable neurological outcome. We estimated the impact of the presence of a prehospital physician on outcomes using a propensity score analysis with inverse probability weighting. We enrolled 1269 patients. Favorable neurological outcomes occurred in 25 of 316 (7.9%) patients with prehospital physicians and 94 of 953 (9.9%) patients without prehospital physicians. In the propensity score analysis, favorable neurological outcomes did not differ between 2 groups (odds ratio = 0.72; 95% confidence interval: 0.44-1.17). The 1-month favorable neurological outcome was not associated with the presence of a prehospital physician for patients with OHCA who underwent EPCR.

摘要

对于接受体外心肺复苏(ECPR)的院外心脏骤停(OHCA)患者,院前医生到场的有效性尚不清楚。在这项多中心、回顾性、观察性研究中,我们纳入了年龄≥18岁、发生OHCA并接受ECPR的患者。主要结局是1个月时良好的神经功能结局。我们使用倾向评分分析和逆概率加权法评估院前医生到场对结局的影响。我们共纳入了1269例患者。316例有院前医生的患者中有25例(7.9%)获得了良好的神经功能结局,953例没有院前医生的患者中有94例(9.9%)获得了良好的神经功能结局。在倾向评分分析中,两组之间良好的神经功能结局没有差异(优势比=0.72;95%置信区间:0.44-1.17)。对于接受ECPR的OHCA患者,1个月时良好的神经功能结局与院前医生的到场无关。

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