Department of Emergency Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City 600, Taiwan.
Graduate School of Design, National Yunlin University of Science and Technology, Yunlin 640, Taiwan.
Int J Environ Res Public Health. 2023 Feb 3;20(3):2713. doi: 10.3390/ijerph20032713.
The Emergency Medical Services (EMS) system faced overwhelming challenges during the coronavirus disease 2019 (COVID-19) pandemic. However, further information is required to determine how the pandemic affected the EMS response and the clinical outcomes of out-of-hospital cardiac arrest (OHCA) patients in COVID-19 low-incidence cities. A retrospective study was conducted in Chiayi, Taiwan, a COVID-19 low-incidence urban city. We compared the outcomes and rescue records before (2018-2019) and during (2020-2021) the COVID-19 pandemic. A total of 567 patients before and 497 during the pandemic were enrolled. Multivariate analysis revealed that the COVID-19 pandemic had no significant influence on the achievement of return of spontaneous circulation (ROSC) and sustained ROSC but was associated with lower probabilities of survival to discharge (aOR = 0.43, 95% CI: 0.21-0.89, = 0.002) and discharge with favorable neurologic outcome among OHCA patients (aOR = 0.35, 95% CI: 0.16-0.77, = 0.009). Patients' ages and OHCA locations were also discovered to be independently related to survival results. The overall impact of longer EMS rescue times on survival outcomes during the pandemic was not significant, with an exception of the specific group that experienced prolonged rescue times (total EMS time > 21 min).
在 2019 冠状病毒病（COVID-19）大流行期间，紧急医疗服务（EMS）系统面临着巨大的挑战。然而，需要进一步的信息来确定大流行如何影响 EMS 反应以及 COVID-19 低发病率城市院外心脏骤停（OHCA）患者的临床结局。在台湾嘉义市进行了一项回顾性研究，该城市为 COVID-19 低发病率城市。我们比较了 COVID-19 大流行前后（2018-2019 年和 2020-2021 年）的结局和救援记录。共纳入 567 例 COVID-19 大流行前和 497 例 COVID-19 大流行期间的患者。多变量分析显示，COVID-19 大流行对实现自主循环恢复（ROSC）和持续 ROSC 没有显著影响，但与 OHCA 患者的存活率降低（aOR = 0.43，95%CI：0.21-0.89， = 0.002）和出院时神经功能良好的可能性降低相关（aOR = 0.35，95%CI：0.16-0.77， = 0.009）。还发现患者年龄和 OHCA 地点与生存结果独立相关。在大流行期间，EMS 救援时间延长对生存结果的总体影响并不显著，但在经历救援时间延长（总 EMS 时间>21 分钟）的特定组中除外。
