Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, Australia.
School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
Prehosp Emerg Care. 2024;28(3):431-437. doi: 10.1080/10903127.2023.2230595. Epub 2023 Jul 10.
Research into suicide-related out-of-hospital cardiac arrests (OHCA) using OHCA registries is scant. A more complete understanding of methods, patient characteristics, and outcomes is essential to inform prehospital management strategies and public health interventions.
Included were all OHCA attended by Queensland Ambulance Service (Australia) paramedics between 1 January 2007 and 31 December 2020, where suicide-related causes could be identified. Age- and sex-standardized incidence rates were calculated. Suicide methods, patient characteristics, and survival outcomes were described. Factors associated with survival outcomes were investigated.
Seven thousand three hundred and fifty-six suicide-related OHCA cases were included. The incidence rates increased from 9.0 per 100,000 population in 2007 to 12.4 in 2020. The incidence rates for males were four times those for females; however, incidence rates for females have increased faster than for males. Hanging was the most common suicide method (63%). Twenty-three percent of patients received resuscitation attempts by paramedics. Among those, the rates of return of spontaneous circulation (ROSC) sustained to hospital arrival, survival to hospital discharge, and survival to 30 days were 28.6, 8.5, and 8.0%, respectively. Over time, the rates of ROSC upon hospital arrival increased, whereas the rates of survival to discharge and 30-day survival remained stable.
The incidence of prehospital-identified suicide-related OHCA in Queensland has increased over time. The prognosis of suicide-related OHCA is poor. Prevention measures should focus on early identification and treatment of individuals having a high risk of suicide. Emergency medical services need to have sufficient training for telecommunicators and paramedics in suicide risk assessment and identification.
使用院外心脏骤停 (OHCA) 登记处对与自杀相关的 OHCA 进行研究的研究很少。更全面地了解方法、患者特征和结局对于为院前管理策略和公共卫生干预措施提供信息至关重要。
纳入了昆士兰救护车服务（澳大利亚）护理人员在 2007 年 1 月 1 日至 2020 年 12 月 31 日期间治疗的所有与自杀相关的 OHCA 病例，其中可以确定自杀相关原因。计算了年龄和性别标准化发病率。描述了自杀方法、患者特征和生存结局。调查了与生存结局相关的因素。
纳入了 7356 例与自杀相关的 OHCA 病例。发病率从 2007 年的每 100,000 人 9.0 例增加到 2020 年的每 100,000 人 12.4 例。男性的发病率是女性的四倍；然而，女性的发病率增长速度快于男性。上吊是最常见的自杀方法（63%）。23%的患者接受了护理人员的复苏尝试。其中，到达医院时自主循环恢复（ROSC）的比例、存活至出院的比例和存活至 30 天的比例分别为 28.6%、8.5%和 8.0%。随着时间的推移，到达医院时的 ROSC 比例增加，而出院和 30 天存活的比例保持稳定。
昆士兰州院前确定的与自杀相关的 OHCA 发病率随着时间的推移而增加。与自杀相关的 OHCA 的预后很差。预防措施应侧重于早期识别和治疗有自杀高风险的个体。紧急医疗服务部门需要对电信员和护理人员进行充分的自杀风险评估和识别培训。
