Faculty of Medicine, School of Public Health, University of Vita-Salute San Raffaele, Milano, Italy.
Agenzia Regionale Emergenza Urgenza Headquarters (AREU HQ), Milano, Italy.
J Prev Med Hyg. 2023 May 16;64(1):E87-E91. doi: 10.15167/2421-4248/jpmh2023.64.1.2782. eCollection 2023 Mar.
Out-hospital cardiac arrest (OHCA) is a multi-factor disease. Many studies have correlated OHCA with a patient's lifestyle; unfortunately, less evidence highlights the correlation with meteorological factors. Methods: Analysis of 23959 OHCA rescue performed by the emergency medical system (EMS) of Lombardy Region, the most Italian populated region, in 2018 and 2019, the pre-pandemic era through a retrospective observational cohort study. The aim of the study consists on evaluating the probability of Return Of Spontaneous Circulation (ROSC) during months to highlight potential seasonal impact in ROSC achievement. In March and April, we highlight an increase of ROSC (OR: 1.20 95% CI 1.04-1.31; p < 0.001) compared to other months. During March and April, we highlight an increase of public access defibrillation (PAD) (3.5% vs 2.5%; p < 0.001), and a reduction of overage time of first vehicle on scene (11.5 vs 11.8; p < 0.001) and age of patient (73.5 vs 74.2; p < 0.01). Finally, we highlight a slight reduction of cancer patient (1.6% vs 1.1%; p = 0.01). We didn't register significant differences in the other variables analyzed as: onset place, sex, rescue team and the patient's death before the rescue arrive. We highlight a difference in ROSC probability during the first month of spring. We register few differences in patient characteristics and EMS rescue, though just PAD use and age clinically impact OHCA patients. In this study, we are unable to fully understand the modification of the probability of ROSC in these months. Even though four variables have a statistically significant difference, they can't fully explain this modification. Different variables like meteorological and seasonal factor must be considered. We propose more research on this item.
院外心脏骤停(OHCA)是一种多因素疾病。许多研究都将 OHCA 与患者的生活方式相关联;遗憾的是,较少的证据强调了与气象因素的相关性。方法:通过回顾性观察队列研究,对 2018 年和 2019 年伦巴第大区(意大利人口最多的地区)的紧急医疗系统(EMS)进行的 23959 例 OHCA 救援进行了分析。该研究的目的是评估在不同月份中实现自主循环恢复(ROSC)的概率,以突出 ROSC 实现中潜在的季节性影响。在 3 月和 4 月,与其他月份相比,我们发现 ROSC 的概率增加(OR:1.20 95%CI 1.04-1.31;p<0.001)。在 3 月和 4 月,我们发现公共获取除颤器(PAD)的使用增加(3.5%比 2.5%;p<0.001),第一辆急救车到达现场的时间(11.5 比 11.8;p<0.001)和患者年龄(73.5 比 74.2;p<0.01)减少。最后,我们发现癌症患者略有减少(1.6%比 1.1%;p=0.01)。我们在分析的其他变量中没有发现显著差异,如发病地点、性别、救援队伍以及在救援到达之前患者的死亡。我们在春季的第一个月中发现 ROSC 概率存在差异。我们在患者特征和 EMS 救援方面记录到一些差异,但只有 PAD 使用和年龄对 OHCA 患者具有临床影响。在这项研究中,我们无法完全理解这些月份中 ROSC 概率的变化。尽管有四个变量具有统计学意义,但它们无法完全解释这种变化。必须考虑气象和季节性等其他因素。我们建议对此项目进行更多的研究。