Tjelmeland Ingvild B M, Wnent Jan, Masterson Siobhan, Kramer-Johansen Jo, Ong Marcus Eng Hock, Smith Karen, Skogvoll Eirik, Lefering Rolf, Lim Shir Lynn, Liu Nan, Dicker Bridget, Swain Andrew, Ball Stephen, Gräsner Jan-Thorsten
Division of Prehospital Services, Oslo University Hospital, Norway; Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Norway; University Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany.
University Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany; University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Kiel, Germany; University of Namibia, School of Medicine, Windhoek, Namibia.
Resuscitation. 2023 May;186:109764. doi: 10.1016/j.resuscitation.2023.109764. Epub 2023 Mar 18.
Bystander cardiopulmonary resuscitation (CPR) significantly increases the survival rate after out-of-hospital cardiac arrest. Using population-based registries, we investigated the impact of lockdown due to Covid-19 on the provision of bystander CPR, taking background changes over time into consideration.
Using a registry network, we invited all registries capable of delivering data from 1. January 2017 to 31. December 2020 to participate in this study. We used negative binominal regression for the analysis of the overall results. We also calculated the rates for bystander CPR. For every participating registry, we analysed the incidence per 100000 inhabitants of bystander CPR and EMS-treated patients using Poisson regression, including time trends.
Twenty-six established OHCA registries reported 742 923 cardiac arrest patients over a four-year period covering 1.3 billion person-years. We found large variations in the reported incidence between and within continents. There was an increase in the incidence of bystander CPR of almost 5% per year. The lockdown in March/April 2020 did not impact this trend. The increase in the rate of bystander CPR was also seen when analysing data on a continental level. We found large variations in incidence of bystander CPR before and after lockdown when analysing data on a registry level.
There was a steady increase in bystander CPR from 2017 to 2020, not associated with an increase in the number of ambulance-treated cardiac arrest patients. We did not find an association between lockdown and bystanders' willingness to start CPR before ambulance arrival, but we found inconsistent patterns of changes between registries.
旁观者心肺复苏术（CPR）可显著提高院外心脏骤停后的存活率。我们利用基于人群的登记系统，在考虑到随时间变化的背景因素的情况下，研究了因新冠疫情实施的封锁措施对旁观者实施心肺复苏术的影响。
我们通过登记系统网络，邀请了所有能够提供2017年1月1日至2020年12月31日数据的登记系统参与本研究。我们使用负二项回归分析总体结果。我们还计算了旁观者心肺复苏术的实施率。对于每个参与的登记系统，我们使用泊松回归分析了每10万居民中旁观者心肺复苏术和接受急救医疗服务（EMS）治疗患者的发病率，包括时间趋势。
26个已建立的院外心脏骤停登记系统报告了在四年期间的742923例心脏骤停患者，覆盖13亿人年。我们发现各大洲之间以及洲内报告的发病率存在很大差异。旁观者心肺复苏术的发病率每年几乎增加5%。2020年3月/4月的封锁并未影响这一趋势。在大陆层面分析数据时，也发现了旁观者心肺复苏术实施率的增加。在登记系统层面分析数据时，我们发现封锁前后旁观者心肺复苏术的发病率存在很大差异。
2017年至2020年期间，旁观者心肺复苏术稳步增加，与接受救护车治疗的心脏骤停患者数量增加无关。我们未发现封锁与旁观者在救护车到达前进行心肺复苏术的意愿之间存在关联，但我们发现各登记系统之间的变化模式不一致。
