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作者信息

Grubic Nicholas, Allan Katherine S, Ghamarian Ehsan, Lin Steve, Lebovic Gerald, Dorian Paul

机构信息

Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

Division of Cardiology, Unity Health Toronto-St. Michael's Hospital, Toronto, Ontario, Canada.

出版信息

CJC Open. 2024 Oct 9;7(1):88-99. doi: 10.1016/j.cjco.2024.09.015. eCollection 2025 Jan.

Abstract

BACKGROUND

Out-of-hospital cardiac arrest (OHCA) remains a prominent medical concern worldwide. Epidemiologic metrics and trends over time for OHCA cases in Canada are not well defined. This study evaluated geographic differences in the incidence and outcomes of OHCA patients admitted to hospitals across Canada, during the period 2013-2017.

METHODS

This population-based retrospective cohort study included 10,492 nontraumatic OHCA patients aged 2-85 years (66% male) who were admitted to an acute-care hospital in any Canadian province or territory (excluding Quebec) between 2013 and 2017. Overall age- and sex-standardized incidence measures (per 100,000 population per year) were calculated through direct standardization to the 2016 Canadian population. Temporal trends in incidence and survival to hospital discharge were evaluated.

RESULTS

The overall age- and sex-standardized incidence of OHCA patients admitted to the hospital was 8.3 per 100,000 population per year, which did not change significantly from 2013 to 2017 (incidence rate ratio: 1.01, 95% confidence interval: 0.99-1.02). The incidence was highest in British Columbia (9.2 per 100,000 population per year), Manitoba (9.0 per 100,000 population per year), and Nova Scotia (9.0 per 100,000 population per year), and lowest in New Brunswick (6.5 per 100,000 population per year), Prince Edward Island (6.8 per 100,000 population per year), and Saskatchewan (7.5 per 100,000 population per year). The proportion of OHCA patients who survived to hospital discharge was highest in Prince Edward Island (57%) and lowest in Ontario (38%). No significant trend in rates of survival to hospital discharge was observed from 2013 (43%) to 2017 (42%;  = 0.86).

CONCLUSIONS

The age- and sex-standardized incidence of OHCA patients admitted to the hospital, and their survival outcomes, were stable in Canada from 2013 to 2017, with considerable variation noted across geographic regions.

摘要

背景

院外心脏骤停(OHCA)仍是全球关注的重要医学问题。加拿大OHCA病例的流行病学指标和随时间变化的趋势尚不明确。本研究评估了2013年至2017年期间加拿大各地医院收治的OHCA患者在发病率和预后方面的地理差异。

方法

这项基于人群的回顾性队列研究纳入了10492名年龄在2至85岁之间的非创伤性OHCA患者(男性占66%),这些患者于2013年至2017年期间被加拿大任何省份或地区(不包括魁北克)的一家急症医院收治。通过直接标准化到2016年加拿大人口,计算总体年龄和性别标准化发病率(每年每10万人)。评估发病率和出院存活率的时间趋势。

结果

入院的OHCA患者总体年龄和性别标准化发病率为每年每10万人8.3例,2013年至2017年无显著变化(发病率比:1.01,95%置信区间:0.99 - 1.02)。发病率在不列颠哥伦比亚省(每年每10万人9.2例)、马尼托巴省(每年每10万人9.0例)和新斯科舍省(每年每10万人9.0例)最高,在新不伦瑞克省(每年每10万人6.5例)、爱德华王子岛省(每年每10万人6.8例)和萨斯喀彻温省(每年每10万人7.5例)最低。OHCA患者出院存活率在爱德华王子岛省最高(57%),在安大略省最低(38%)。2013年(43%)至2017年(42%;P = 0.86)未观察到出院存活率的显著趋势。

结论

2013年至2017年期间,加拿大入院的OHCA患者的年龄和性别标准化发病率及其生存结局保持稳定,但不同地理区域存在显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07c7/11763608/b99f69c3fd69/ga1.jpg

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