Nishimura Takeshi, Suga Masafumi, Hongo Takashi, Yumoto Tetsuya, Nakao Atsunori, Ishihara Satoshi, Naito Hiromichi
Department of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan.
Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Japan.
Resusc Plus. 2023 Aug 5;15:100434. doi: 10.1016/j.resplu.2023.100434. eCollection 2023 Sep.
Until recently, calls to the emergency medical service (EMS) from landline phones, which display the caller's exact location at the dispatch center, had been common. Since the use of mobile phones has become widespread, many emergency calls are now made from mobile phones. Differences in outcomes of out-of-hospital cardiac arrest (OHCA) patients for whom EMS was called from mobile versus landline phones has not yet been fully elucidated.
We performed a retrospective, population-based analysis in Kobe, Japan to examine whether EMS calls from mobiles improved the prognosis of OHCA patients over EMS calls placed from landlines. The primary outcome was favorable neurological outcome, defined as Cerebral Performance Category (CPC) scores of 1 or 2 at discharge. Secondary outcomes were survival at one-month, survival at discharge, and time durations between call and EMS activities.
Of 4,231 OHCA cases, 2,194 cases (706 landline cases vs. 1,488 mobile cases) were included in this study. The percentages of favorable neurological outcomes were 0.7% (5/706) in the landline group and 3.8% (56/1,488) in the mobile group. Adjusted multivariable logistic regression revealed that favorable neurological outcomes (odds ratio [OR] 3.03, 95% confidence interval [CI] 1.12-8.17, = 0.03) were better in the mobile group, while one-month survival (OR 1.30, 95% CI 0.80-2.14, = 0.29) was not significantly different. Bystander CPR was more frequently administered in the mobile group (landlines 61.3% vs. mobiles 68.4%, < 0.01). Time durations between call to EMS dispatch (184.5 [IQR 157-220 s] vs. 205 [IQR 174-248 s], < 0.01) and EMS arrival (476.5 [IQR 377-599 s] vs. 491 [IQR 407.5-611.5 s], < 0.01) were shorter in the landline group.
Although the landline caller location display system seems effective for shorter times between EMS call and EMS arrival, mobile phone use was associated with better neurological outcomes.
直到最近，通过固定电话拨打紧急医疗服务（EMS）的情况还很常见，固定电话能在调度中心显示来电者的确切位置。自从手机的使用变得广泛以来，现在许多紧急呼叫都是通过手机拨打的。对于通过手机与固定电话拨打EMS的院外心脏骤停（OHCA）患者，其结局差异尚未完全阐明。
我们在日本神户进行了一项基于人群的回顾性分析，以研究通过手机拨打EMS是否比通过固定电话拨打能改善OHCA患者的预后。主要结局是良好的神经功能结局，定义为出院时脑功能分类（CPC）评分为1或2。次要结局是1个月生存率、出院生存率以及呼叫与EMS活动之间的时间间隔。
在4231例OHCA病例中，本研究纳入了2194例（706例固定电话病例与1488例手机病例）。固定电话组良好神经功能结局的百分比为0.7%（5/706），手机组为3.8%（56/1488）。调整后的多变量逻辑回归显示，手机组的良好神经功能结局更好（优势比[OR] 3.03，95%置信区间[CI] 1.12 - 8.17，P = 0.03），而1个月生存率（OR 1.30，95% CI 0.80 - 2.14，P = 0.29）无显著差异。手机组旁观者心肺复苏术的实施频率更高（固定电话组61.3% vs. 手机组68.4%，P < 0.01）。固定电话组从呼叫到EMS调度的时间间隔（184.5 [四分位间距157 - 220秒] vs. 205 [四分位间距174 - 248秒]，P < 0.01）和EMS到达的时间间隔（476.5 [四分位间距377 - 599秒] vs. 491 [四分位间距407.5 - 611.5秒]，P < 0.01）更短。
尽管固定电话来电者位置显示系统似乎对缩短EMS呼叫与EMS到达之间的时间有效，但使用手机与更好的神经功能结局相关。
