Graduate School of Medical and Health Science, Nippon Sport Science University, Kanagawa, Japan.
Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
Prehosp Disaster Med. 2023 Jun;38(3):326-331. doi: 10.1017/S1049023X23000353. Epub 2023 Mar 20.
Foreign body airway obstruction (FBAO) is a life-threatening emergency, and the prognosis of patients with FBAO is greatly affected by the prehospital process. There are only a few large-scale studies analyzing prehospital process databases of the fire department.
The aim of this study was to investigate whether characteristics of patients with FBAO were associated with prehospital factors and outcomes.
In this retrospective observational study, patients transferred to the hospital by the Tokyo, Japan Fire Department for FBAO from 2017 through 2019 were included. The association between neurologically favorable survival among the characteristics of patients with FBAO and prehospital factors affecting the outcomes was evaluated.
Of the 2,429,175 patients, 3,807 (0.2%) patients had FBAO. The highest number of FBAO cases was 99 (2.6%), which occurred on January 1 (New Year's Day), followed by 40 cases (1.1%) on January 2, and 28 cases (0.7%) on January 3. The number of patients who experienced out-of-hospital cardiac arrest (OHCA) caused by FBAO was 1,644 (43.2%). Comparing the OHCA and non-OHCA groups, there were significant differences in age, sex, time spent at the site, and distance between the site and hospital. Cardiac arrest was significantly lower in infants after FBAO (P < .001). In total, 98.2% of patients who did not have return of spontaneous circulation (ROSC) before hospital arrival died within 30 days, a significantly higher mortality rate than that in patients who had ROSC (98.2% versus 65.8%; P < .001).
Among patients who did not have ROSC following FBAO upon arrival at the hospital, 98.2% died within 30 days. Thus, it is important to remove foreign bodies promptly and provide sufficient ventilation to the patient at the scene to increase the potential for ROSC. Further, more precautions should be exercised to prevent FBAO at the beginning of the year.
异物气道阻塞（FBAO）是一种危及生命的紧急情况，患者的预后受院前过程的影响很大。只有少数大规模研究分析了消防部门的院前过程数据库。
本研究旨在探讨 FBAO 患者的特征是否与院前因素和结局相关。
在这项回顾性观察研究中，纳入了 2017 年至 2019 年期间由日本东京消防署转院治疗 FBAO 的患者。评估 FBAO 患者特征中神经功能良好存活与影响结局的院前因素之间的关联。
在 2,429,175 名患者中，有 3,807 名（0.2%）患者患有 FBAO。FBAO 病例数最多的是 99 例（2.6%），发生在 1 月 1 日（元旦），其次是 40 例（1.1%）发生在 1 月 2 日，28 例（0.7%）发生在 1 月 3 日。因 FBAO 导致院外心脏骤停（OHCA）的患者有 1,644 例（43.2%）。比较 OHCA 和非 OHCA 组，在年龄、性别、在现场的时间和现场与医院之间的距离方面存在显著差异。在 FBAO 后婴儿发生心脏骤停的情况明显减少（P<0.001）。总的来说，在到达医院前未恢复自主循环（ROSC）的患者中，有 98.2%的患者在 30 天内死亡，死亡率明显高于 ROSC 患者（98.2%比 65.8%；P<0.001）。
在到达医院时未发生 FBAO 后 ROSC 的患者中，有 98.2%的患者在 30 天内死亡。因此，及时清除异物并向患者提供充足的通气以增加 ROSC 的可能性非常重要。此外，年初应更加小心，防止 FBAO 的发生。
