Waalewijn R A, de Vos R, Koster R W
Department of Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands. R.A.
Resuscitation. 1998 Sep;38(3):157-67. doi: 10.1016/s0300-9572(98)00102-6.
The purpose of this study was to describe the chain of survival in Amsterdam and its surroundings and to suggest areas for improvement. To ensure accurate data, collection was made by research personnel during the resuscitation, according to the Utstein recommendations. Between June 1, 1995 and August 1, 1997 all consecutive cardiac arrests were registered. Patient characteristics, resuscitation characteristics and time intervals were analyzed in relation to survival. From the 1046 arrests with a cardiac etiology and where resuscitation was attempted, 918 cases were not witnessed by EMS personnel. The analysis focussed on these 918 patients of whom 686 (75%) died during resuscitation, 148 (16%) died during hospital admission and 84 patients (9%) survived to hospital discharge. Patient and resuscitation characteristics associated with survival were: age, VF as initial rhythm, witnessed arrest and bystander CPR. EMS arrival time was significantly shorter for survivors (median 9 min) compared to non-survivors (median 11 min). In 151 cases the police was also alerted and arrived 5 min (median) earlier than EMS personnel. Using the OPC/CPC good functional health was observed in 50% of the survivors and moderate performance in 29%. All links in the chain of survival must be strengthened, but equipping the police with semi-automatic defibrillators may be the most useful intervention to improve survival.
本研究的目的是描述阿姆斯特丹及其周边地区的生存链，并提出改进领域。为确保数据准确，研究人员根据乌斯坦建议在复苏过程中进行收集。在1995年6月1日至1997年8月1日期间，对所有连续性心脏骤停进行了登记。分析了患者特征、复苏特征和时间间隔与生存的关系。在1046例心脏病因且尝试进行复苏的骤停病例中，918例未被急救医疗服务人员目击。分析集中在这918例患者身上，其中686例（75%）在复苏过程中死亡，148例（16%）在住院期间死亡，84例（9%）存活至出院。与生存相关的患者和复苏特征包括：年龄、初始心律为室颤、目击骤停和旁观者实施心肺复苏。与未存活者（中位数11分钟）相比，存活者的急救医疗服务到达时间显著更短（中位数9分钟）。在151例病例中，警方也接到警报，比急救医疗服务人员早5分钟（中位数）到达。在50%的存活者中观察到良好的功能健康状况，29%的存活者表现中等。生存链中的所有环节都必须加强，但为警方配备半自动除颤器可能是提高生存率最有效的干预措施。
