旁观者心肺复苏术、自动体外除颤器的使用与院外心脏骤停后存活率的关系。

Bystander cardiopulmonary resuscitation, automated external defibrillator use, and survival after out-of-hospital cardiac arrest.

机构信息

Department of Emergency Medicine, Seoul National University Hospital, South Korea.

Department of Emergency Medicine, Seoul National University Hospital, South Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, South Korea.

出版信息

Am J Emerg Med. 2023 Apr;66:85-90. doi: 10.1016/j.ajem.2023.01.033. Epub 2023 Jan 24.

DOI:10.1016/j.ajem.2023.01.033

PMID:36736064

Abstract

INTRODUCTION

We aimed to investigate the association between bystander cardiopulmonary resuscitation (CPR) with and without automated external defibrillator (AED) use and neurological outcomes after out-of-hospital cardiac arrest (OHCA) in Korea.

METHODS

This cross-sectional study used a nationwide Korean OHCA registry between 2015 and 2019. Patients were categorised into no bystander CPR and bystander CPR with and without AED use groups. The primary outcome was good neurological recovery at discharge. We also analysed the interaction effects of place of arrest, response time, and whether the OHCA was witnessed.

RESULTS

In total, 93,623 patients were included. Among them, 35,486 (37.9%) were in the no bystander CPR group, 56,187 (60.0%) were in the bystander CPR without AED use group, and 1950 (2.1%) were in the bystander CPR with AED use group. Good neurological recovery was demonstrated in 1286 (3.6%), 3877 (6.9%), and 208 (10.7%) patients in the no CPR, bystander CPR without AED use, and bystander CPR with AED use groups, respectively. Compared to the no bystander CPR group, the adjusted odds ratio (95% confidence intervals) for good neurological recovery was 1.54 (1.45-1.65) and 1.37 (1.15-1.63) in the bystander CPR without and with AED use groups, respectively. The effect of bystander CPR with AED use was more apparent in OHCAs with witnessed arrest and prolonged response time (≥8 min).

CONCLUSION

Bystander CPR was associated with better neurological recovery compared to no bystander CPR; however, the benefits of AED use were not significant. Efforts to disseminate bystander AED availability and ensure proper utilisation are warranted.

摘要

简介

本研究旨在调查韩国院外心脏骤停（OHCA）患者中旁观者心肺复苏（CPR）伴或不伴体外自动除颤器（AED）使用与神经功能结局之间的关系。

方法

本研究采用了 2015 年至 2019 年期间的全国性韩国 OHCA 注册数据进行了一项横断面研究。患者分为无旁观者 CPR 组和有旁观者 CPR 伴或不伴 AED 使用组。主要结局为出院时的良好神经恢复。我们还分析了发病地点、反应时间和 OHCA 是否目击的交互作用效应。

结果

共纳入 93623 例患者。其中，35486 例（37.9%）为无旁观者 CPR 组，56187 例（60.0%）为无旁观者 CPR 不伴 AED 使用组，1950 例（2.1%）为有旁观者 CPR 伴 AED 使用组。无 CPR、无旁观者 CPR 不伴 AED 使用和有旁观者 CPR 伴 AED 使用组的良好神经恢复分别为 1286 例（3.6%）、3877 例（6.9%）和 208 例（10.7%）。与无旁观者 CPR 组相比，有旁观者 CPR 不伴 AED 使用组和有旁观者 CPR 伴 AED 使用组的良好神经恢复的调整优势比（95%置信区间）分别为 1.54（1.45-1.65）和 1.37（1.15-1.63）。在目击发病和反应时间延长（≥8 分钟）的 OHCA 中，有旁观者 CPR 伴 AED 使用的效果更为明显。