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紧急医疗服务响应时间对院外心脏骤停患者生存率的影响:一项5年回顾性研究。

Effects of Emergency Medical Service Response Time on Survival Rate of Out-of-Hospital Cardiac Arrest Patients: a 5-Year Retrospective Study.

作者信息

Damdin Siriporn, Trakulsrichai Satariya, Yuksen Chaiyaporn, Sricharoen Pungkava, Suttapanit Karn, Tienpratarn Welawat, Liengswangwong Wijittra, Seesuklom Suteenun

机构信息

Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Arch Acad Emerg Med. 2025 Feb 25;13(1):e36. doi: 10.22037/aaemj.v13i1.2596. eCollection 2025.

Abstract

INTRODUCTION

Emergency medical service (EMS) response time is a critical factor in managements of out-of-hospital cardiac arrest (OHCA) cases. This study aimed to investigate the effects of EMS response time on survival of OHCA patients.

METHODS

This study employed a retrospective cohort design focused on prognosis research. Data was collected from the Erawan EMS Dispatch Center of the Bangkok Metropolitan Administration from January 2019 to December 2023. All OHCA cases visited by dispatched prehospital teams in Bangkok were included. Multivariable logistic regression was used to analyze the effect of response time on survival at scene, survival to emergency department (ED), and survival to hospital discharge of OHCA cases.

RESULTS

Among the 5,433 OHCA patients included in the study, 29.17% achieved return of spontaneous circulation at the scene, 6.9% survived to ED, and 1% survived to hospital discharge. Each 1-minute increase in response time decreased the likelihood of survival at the scene by 6% (OR: 0.94, p < 0.001), survival to ED admission by 4% (OR: 0.96, p < 0.001), and survival to hospital discharge by 6% (OR: 0.94, p = 0.006). Response times under 8 minutes significantly improved outcomes, with survival at the scene increasing by 2.31 times (p < 0.001), survival to ED by 1.76 times (p < 0.001), and survival to hospital discharge by 2.09 times (p = 0.048).

CONCLUSIONS

A maximum response time of 8 minutes significantly enhances survival outcomes, including survival at the scene, survival to ED, and survival to hospital discharge. Furthermore, each 1-minute increase in response time is associated with a 6% reduction in the likelihood of survival to hospital discharge.

摘要

引言

紧急医疗服务(EMS)响应时间是院外心脏骤停(OHCA)病例管理中的一个关键因素。本研究旨在调查EMS响应时间对OHCA患者生存的影响。

方法

本研究采用回顾性队列设计,重点进行预后研究。数据收集自2019年1月至2023年12月曼谷市行政区域的Erawan EMS调度中心。纳入了曼谷市所有由院前急救团队出诊的OHCA病例。采用多变量逻辑回归分析响应时间对OHCA病例现场存活、存活至急诊科(ED)以及存活至出院的影响。

结果

在纳入研究的5433例OHCA患者中,29.17%在现场实现自主循环恢复,6.9%存活至急诊科,1%存活至出院。响应时间每增加1分钟,现场存活的可能性降低6%(比值比:0.94,p<0.001),存活至ED入院的可能性降低4%(比值比:0.96,p<0.001),存活至出院的可能性降低6%(比值比:0.94,p = 0.006)。8分钟以内的响应时间显著改善了预后,现场存活率提高了2.31倍(p<0.001),存活至ED的概率提高了1.76倍(p<0.001),存活至出院的概率提高了2.09倍(p = 0.048)。

结论

最长8分钟的响应时间显著提高了生存结局,包括现场存活、存活至急诊科以及存活至出院。此外,响应时间每增加1分钟,存活至出院的可能性降低6%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f51/12065030/bfb9dbf834a7/aaem-13-e36-g001.jpg

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