Department of Emergency Medicine, Seoul National University Hospital, Republic of Korea.
Department of Emergency Medicine, Seoul National University Hospital, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea.
Resuscitation. 2023 Aug;189:109839. doi: 10.1016/j.resuscitation.2023.109839. Epub 2023 May 15.
This study aimed to evaluate whether the relationship between bystanders and victims is associated with neurological outcomes in paediatric out-of-hospital cardiac arrest (OHCA).
This cross-sectional, retrospective, observational study included patients with non-traumatic paediatric OHCA undergoing emergency medical service treatment between 2014 and 2021. The relationship between bystanders and patients was categorized into first responder, family, and layperson groups. The primary outcome was good neurological recovery. Further sensitivity analyses were conducted subcategorizing the cohort into four groups: first responder, family, friends or colleagues, and layperson, or two groups: family and non-family.
We analysed 1,451 patients. OHCAs in the family group showed lower rate of good neurological outcomes regardless of witness status: 29.4%, 12.3%, and 38.6% in the first responder, family, and layperson groups in the witnessed and 6.7%, 2.0%, and 7.3% in the unwitnessed cohort. Multivariable logistic regression yielded no significant differences between the three groups: the adjusted odds ratios (AOR) and 95% confidence interval (CI) were 0.57 (0.28-1.15) in the family and 1.18 (0.61-2.29) in the layperson compared to the first responder group. The sensitivity analysis yielded a higher probability of good neurologic recovery in the non-family compared to the family member bystander group in witnessed cohort (AOR, 1.96; 95% CI, 1.17-3.30).
Paediatric OHCAs had no significant difference between good neurological recovery and the relationship of bystander.
本研究旨在评估旁观者与患儿之间的关系是否与儿科院外心脏骤停（OHCA）患者的神经功能结局相关。
本回顾性、横断面观察性研究纳入了 2014 年至 2021 年接受急救医疗服务治疗的非创伤性儿科 OHCA 患者。旁观者与患者的关系分为急救人员、家属和非专业人士。主要结局为神经功能良好恢复。进一步的敏感性分析将队列分为 4 组：急救人员、家属、朋友或同事和非专业人士，或分为 2 组：家属和非家属。
我们分析了 1451 例患者。无论目击者状态如何，家族组 OHCA 的神经功能良好恢复率均较低：目击者中急救人员、家属和非专业人士组分别为 29.4%、12.3%和 38.6%，非目击者中分别为 6.7%、2.0%和 7.3%。多变量逻辑回归显示三组之间无显著差异：在家族组，调整后的比值比（AOR）和 95%置信区间（CI）为 0.57（0.28-1.15），而在非专业人士组为 1.18（0.61-2.29），与急救人员组相比。敏感性分析显示，在目击者队列中，非家属旁观者的神经功能良好恢复的可能性高于家属旁观者（AOR，1.96；95%CI，1.17-3.30）。
儿科 OHCA 患者的神经功能良好恢复与旁观者关系之间无显著差异。
