School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Centre for Research and Evaluation,Ambulance Victoria, Blackburn North, Victoria, Australia; Department of Paramedicine, Monash University, Frankston, Victoria, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Alfred Hospital,Alfred Health, Prahran, Victoria, Australia.
Resuscitation. 2023 Oct;191:109932. doi: 10.1016/j.resuscitation.2023.109932. Epub 2023 Aug 8.
Awareness of heart attack symptoms may enhance health-seeking behaviour and prevent premature deaths from out-of-hospital cardiac arrest (OHCA). We sought to investigate the impact of a national awareness campaign on emergency medical service (EMS) attendances for chest pain and OHCA.
Between January 2005 and December 2017, we included registry data for 97,860 EMS-attended OHCA cases from 3 Australian regions and dispatch data for 1,631,217 EMS attendances for chest pain across 5 Australian regions. Regions were exposed to between 11 and 28 months of television, radio, and print media activity. Multivariable negative binomial models were used to explore the effect of campaign activity on the monthly incidence of EMS attendances for chest pain and OHCA.
Months with campaign activity were associated with an 8.8% (IRR 1.09, 95% CI: 1.07, 1.11) increase in the incidence of EMS attendances for chest pain and a 5.6% (IRR 0.94, 95% CI: 0.92, 0.97) reduction in OHCA attendances. Larger intervention effects were associated with increasing months of campaign activity, increasing monthly media spending and media exposure in 2013. In stratified analyses of OHCA cases, the largest reduction in incidence during campaign months was observed for unwitnessed arrests (IRR 0.93, 95% CI: 0.90, 0.96), initial non-shockable arrests (IRR 0.93, 95% CI: 0.90, 0.97) and arrests occurring in private residences (IRR 0.95, 95% CI: 0.91, 0.98).
A national awareness campaign targeting knowledge of heart attack symptoms was associated with an increase in EMS use for chest pain and a reduction in OHCA incidence and may serve as an effective primary prevention strategy for OHCA.
对心脏病发作症状的认识可能会增强寻求健康的行为，并防止院外心脏骤停（OHCA）导致的过早死亡。我们旨在研究一项全国性意识运动对胸痛和 OHCA 的紧急医疗服务（EMS）就诊的影响。
在 2005 年 1 月至 2017 年 12 月期间，我们纳入了来自澳大利亚 3 个地区的 97860 例 EMS 治疗的 OHCA 病例的登记数据，以及来自澳大利亚 5 个地区的 1631217 例胸痛的 EMS 就诊的调度数据。这些地区接受了 11 至 28 个月的电视、广播和平面媒体活动。使用多变量负二项式模型来探讨活动对胸痛和 OHCA 的 EMS 就诊每月发生率的影响。
活动期间的月份与 EMS 就诊胸痛的发生率增加 8.8%（IRR 1.09，95%CI：1.07，1.11）和 OHCA 就诊率降低 5.6%（IRR 0.94，95%CI：0.92，0.97）相关。随着活动月数的增加、每月媒体支出的增加以及 2013 年的媒体曝光度的增加，干预效果也更大。在 OHCA 病例的分层分析中，观察到活动月期间发生率下降幅度最大的是无人见证的逮捕（IRR 0.93，95%CI：0.90，0.96）、初始非电击可除颤逮捕（IRR 0.93，95%CI：0.90，0.97）和发生在私人住宅的逮捕（IRR 0.95，95%CI：0.91，0.98）。
针对心脏病发作症状知识的全国性意识运动与 EMS 治疗胸痛的使用率增加以及 OHCA 发生率降低相关，可能是 OHCA 的一种有效初级预防策略。
