Epidemiology and outcome of adult out-of-hospital cardiac arrest of non-cardiac origin in Osaka: a population-based study.
Epidemiology and outcome of adult out-of-hospital cardiac arrest of non-cardiac origin in Osaka: a population-based study.
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DOI：
10.1136/bmjopen-2014-006462
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发表时间：
2014-12-22
期刊：
影响因子：
2.9
通讯作者：
Shimazu T
中科院分区：
文献类型：
--
作者：
Kitamura T;Kiyohara K;Sakai T;Iwami T;Nishiyama C;Kajino K;Nishiuchi T;Hayashi Y;Katayama Y;Yoshiya K;Shimazu T
通过详细分析院外心脏骤停（ohca）的非心源性原因和与非心源性心脏骤停后预后相关的因素，评价院外心脏骤停（ohca）的流行病学特征。一项前瞻性、基于人群的观察性研究。Utstein大阪项目。2005年1月至2011年12月，14 164名年龄≥20岁的非心源性ohca成年患者经急救医务人员或旁观者抢救后送往医疗机构。OHCA术后1个月生存率。多重逻辑回归分析用于评估与结果潜在相关的因素。研究期间，1个月生存率为5.3%（755/14 164）。外因患者1个月生存率为6.2%(510/8239)，呼吸系统疾病患者为6.5%(94/1148)，恶性肿瘤患者为0.8%(11/1309)，中风患者为4.9%(55/1114)，其他患者为4.1%（85/2054）。外因的1个月生存率分别为：窒息14.3%（382/2670）、上吊4.2%（84/1999）、坠落0.7%（9/1300）、溺水1.1%（12/1062）、交通伤害1.6%（12/765）、药物滥用3.7%（7/187）、未分类外因1.6%（4/256）。在一项多变量分析中，年龄<65岁的成年人在旁观者的见证下发生心脏骤停，在心脏骤停前有正常的日常生活活动，有心室颤动骤停，在公共场所有骤停，静脉液体水平和早期紧急医疗服务反应时间是非心脏源性ohca后1个月预后的重要预测因素。所有非心脏来源的ohca的1个月生存率没有显著增加（从2005年的4.3%（86/2023）增加到2011年的4.9%(105/2126)），每增加一年的调整OR为1.01 （95% CI 0.97 ~ 1.06）。从大阪的大型OHCA登记中，我们证明了非心源性OHCA后的1个月生存率较差且稳定。
To evaluate epidemiological characteristics of out-of-hospital cardiac arrests (OHCAs) by detailed non-cardiac cause and factors associated with the outcomes after OHCAs of non-cardiac origin. A prospective, population-based observational study. The Utstein Osaka Project. 14 164 adult patients aged ≥20 years old with OHCAs due to non-cardiac origin who were resuscitated by emergency-medical-service personnel or bystanders, and then were transported to medical institutions from January 2005 to December 2011. One-month survival after OHCA. Multiple logistic regression analysis was used to assess factors that were potentially associated with the outcome. During the study period, the 1-month survival rate was 5.3% (755/14 164). The proportion of 1-month survival was 6.2% (510/8239) in external causes, 6.5% (94/1148) in respiratory diseases, 0.8% (11/1309) in malignant tumours, 4.9% (55/1114) in strokes and 4.1% (85/2054) in others. As for external causes, the proportion of 1-month survival was 14.3% (382/2670) in asphyxia, 4.2% (84/1999) in hanging, 0.7% (9/1300) in fall, 1.1% (12/1062) in drowning, 1.6% (12/765) in traffic injury, 3.7% (7/187) in drug overuse and 1.6% (4/256) in unclassified external causes. In a multivariate analysis, adults aged <65 years old with arrests witnessed by bystanders, with normal activities of daily living before the arrests, having ventricular fibrillation arrests, having arrests in public places, intravenous fluid levels and early Emergency Medical Service response time were significant predictors for 1-month outcome after OHCAs of non-cardiac origin. The proportion of 1-month survival of all OHCAs of non-cardiac origin did not significantly increase (from 4.3% (86/2023) in 2005 to 4.9% (105/2126) in 2011) and the adjusted OR for one-increment of year was 1.01 (95% CI 0.97 to 1.06). From a large OHCA registry in Osaka, we demonstrated that 1-month survival after OHCAs of non-cardiac origin was poor and stable.
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