Pegani Carlo, Peratoner Alberto, Andrian Manila, Magagnin Laura, Gambolò Luca, Pravisani Alice, Zuliani Michele, Rakar Serena, Lutman Cristina, Mattia Alessio Della, Fabretto Katya, Tullio Annarita, Stirparo Giuseppe, Pognuz Erik Roman, Ristagno Giuseppe
Prehospital Emergency Medical Service, Department of Anaesthesia and Intensive Care, Cattinara Hospital, University of Trieste, Trieste, Italy.
Regional Emergency Medical Dispatch Centre, Central Regional Health Agency, Udine, Italy.
Resusc Plus. 2025 Jun 10;25:101000. doi: 10.1016/j.resplu.2025.101000. eCollection 2025 Sep.
Out-of-hospital cardiac arrest (OHCA) presents significant regional variations in incidence, management, and survival rates. The Friuli-Venezia-Giulia (FVG) region in northeastern Italy has established a cardiac arrest registry to evaluate epidemiological trends and the effectiveness of its emergency medical service (EMS) interventions. This study analyses EMS-treated OHCAs over a three-year period, focusing on patient characteristics, resuscitation practices, and survival outcomes.
A retrospective cohort study was conducted using prospectively collected data from the FVG-OHCA registry between January 2021-December 2023. All adult OHCAs where resuscitation was attempted by EMS were included. Demographics, OHCA characteristics, bystander interventions, EMS response and treatments, and outcomes were analysed. Logistic regression was used to identify factors associated with survival to hospital admission, six-month survival, and good neurological recovery (Cerebral Performance Category (CPC) 1-2).
A total of 4,089 OHCA cases were recorded, with an incidence of 113/100,000 inhabitants/year. Although bystander CPR rate was 67%, public AED use was low (4.3%). Resuscitation was attempted by EMS in 48% of cases, and an advanced airway was placed in 75% of patients. Survival to hospital admission was 22.9%, while six-month survival was 9.7%, and 7.6% of patients had a CPC 1-2. Younger age, male gender, shockable rhythm, and public location were associated with long-term survival. High-quality bystander CPR, use of mechanical CPR, and advanced airway placement during CPR were associated only with survival to hospital admission.
This study provides comprehensive insights into OHCA epidemiology and outcomes in the FVG region and emphasises the importance of early intervention, high-quality bystander CPR, and specialised prehospital care.
院外心脏骤停（OHCA）在发病率、管理和生存率方面存在显著的地区差异。意大利东北部的弗留利-威尼斯朱利亚（FVG）地区已建立了心脏骤停登记处，以评估流行病学趋势及其紧急医疗服务（EMS）干预措施的有效性。本研究分析了三年期间接受EMS治疗的OHCA患者，重点关注患者特征、复苏实践和生存结果。
采用回顾性队列研究，使用2021年1月至2023年12月期间从FVG-OHCA登记处前瞻性收集的数据。纳入所有由EMS尝试进行复苏的成年OHCA患者。分析人口统计学、OHCA特征、旁观者干预、EMS反应和治疗以及结果。采用逻辑回归分析确定与入院生存、六个月生存以及良好神经功能恢复（脑功能分类（CPC）1-2）相关的因素。
共记录了4089例OHCA病例，发病率为113/10万居民/年。尽管旁观者心肺复苏率为67%，但公众自动体外除颤器（AED）的使用率较低（4.3%）。48%的病例由EMS尝试进行复苏，75%的患者放置了高级气道。入院生存率为22.9%，六个月生存率为9.7%，7.6%的患者CPC为1-2。年龄较小、男性、可电击心律和公共场所与长期生存相关。高质量的旁观者心肺复苏、机械心肺复苏的使用以及心肺复苏期间放置高级气道仅与入院生存相关。
本研究全面深入地了解了FVG地区OHCA的流行病学和结果，并强调了早期干预、高质量旁观者心肺复苏和专业院前护理的重要性。
