Good outcome in every fourth resuscitation attempt is achievable-An Utstein template report from the Stavanger region
Good outcome in every fourth resuscitation attempt is achievable-An Utstein template report from the Stavanger region
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DOI：
10.1016/j.resuscitation.2011.06.016
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发表时间：
2011-12-01
期刊：
影响因子：
6.5
通讯作者：
Lossius, Hans Morten
中科院分区：
文献类型：
--
作者：
Lindner, Thomas Werner;Soreide, Eldar;Lossius, Hans Morten
研究目的：院外心脏骤停（OHCA）是西方世界的主要死亡原因。我们想研究的变化，随着时间的推移，在一个地区，已经报道了高生存率与此相关的因素。方法：我们使用了一个前瞻性收集的Utstein模板数据库，以确定所有的复苏尝试，在成人患者OHCA的假定心脏起源。我们纳入了846次复苏尝试，并比较了两个时间段内的存活率和出院时的良好结局（2001-2005年与2006-2008年）我们发现两个时间段的平均年龄没有显著差异（71岁和70岁（p = 0.309）），性别分布（男性70%和71%（p = 0.708）），OHCA的位置（家庭64%和63%（p = 0.732））、可电击节律的比例（44%和47%（p = 0.261））和自主循环恢复率（38%和43%（p = 0.136））。然而，旁观者心肺复苏（CPR）从60%显著增加到73%（p < 0.0001），总的存活率从18%增加到25%（p = 0.018）。在可电击第一心律的患者中，出院存活率从37%显著增加至48%（p = 0.036）。在目击逮捕与电击节律生存率从37%增加到52%（p = 0.0105）。结论：总体而言，良好的结果是现在实现在每四次复苏尝试，并在每二次复苏尝试时，患者有一个电击的节奏。结果更好的原因很可能是多因素的，并与当地生存链的改善有关。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Aim of the study: Out-of-hospital cardiac arrest (OHCA) is a major cause of death in the western world. We wanted to study changes in survival over time and factors linked to this in a region which have already reported high survival rates.Methods: We used a prospectively collected Utstein template database to identify all resuscitation attempts in adult patients with OHCA of presumed cardiac origin. We included 846 resuscitation attempts and compared survival to discharge with good outcome in two time periods (2001-2005 vs. 2006-2008).Results: We found no significant differences between the two time periods for mean age (71 and 70 years (p = 0.309)), sex distribution (males 70% and 71% (p = 0.708)), location of the OHCA (home 64% and 63% (p = 0.732)), proportion of shockable rhythms (44% and 47% (p = 0.261)) and rate of return of spontaneous circulation (38% and 43% (p = 0.136)), respectively. Bystander cardiopulmonary resuscitation (CPR), however, increased significantly from 60% to 73% (p < 0.0001), as did the overall rate of survival to discharge from 18% to 25% (p = 0.018). In patients with a shockable first rhythm, rate of survival to discharge increased significantly from 37% to 48% (p = 0.036). In witnessed arrest with shockable rhythm survival to discharge increased from 37% to 52% (p = 0.0105).Conclusion: Overall, good outcome is now achievable in every fourth resuscitation attempt and in every second resuscitation attempt when patients have a shockable rhythm. The reason for the better outcomes is most likely multi-factorial and linked to improvements in the local chain of survival. (C) 2011 Elsevier Ireland Ltd. All rights reserved.