Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia: bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in an 18-year perspective
Increase in survival and bystander CPR in out-of-hospital shockable arrhythmia: bystander CPR and female gender are predictors of improved outcome. Experiences from Sweden in an 18-year perspective
复制标题
DOI：
10.1136/hrt.2011.222711
复制
发表时间：
2011-09-01
期刊：
影响因子：
5.7
通讯作者：
Herlitz, Johan
中科院分区：
文献类型：
--
作者：
Adielsson, Anna;Hollenberg, Jacob;Herlitz, Johan
目的从全国的角度，描述由旁观者目击的室颤或无脉性室性心动过速患者的生存情况，并回答两个主要问题：（1）随时间的变化是什么？（2）哪些因素是重要的？设计观察性登记研究。设置瑞典。患者1990年1月1日至2009年12月31日期间纳入瑞典院外心脏骤停登记的所有患者，他们被发现存在旁观者见证的室颤，推测为心脏病因。干预措施旁观者心肺复苏（CPR）和除颤。主要结局指标生存至1个月。结果7187例患者符合设定标准。年龄，院外心脏骤停（OHCA）和性别没有变化。旁观者CPR从46%增加到73%; 95% CI为OR 1.060 - 1.081/年。从虚脱到除颤的中位延迟从12分钟增加到14分钟（趋势p <0.0004）。早期生存率从28%增加到45%（95% CI 1.044到1.065），1个月生存率从12%增加到23%（95% CI 1.058到1.086）。早期和晚期生存的强预测因素是从崩溃到除颤，旁观者心肺复苏术，女性性别和OHCA outside the home.Conclusion在一个长期的角度来看，在瑞典，生存到1个月后，室颤几乎翻了一番。这与旁观者CPR的显著增加有关。结果的强预测因素是除颤的短暂延迟、旁观者CPR、女性和崩溃的位置。
Objectives In a national perspective, to describe survival among patients found in ventricular fibrillation or pulseless ventricular tachycardia witnessed by a bystander and with a presumed cardiac aetiology and answer two principal questions: (1) what are the changes over time? and (2) which are the factors of importance?Design Observational register study.Setting Sweden.Patients All patients included in the Swedish Out of Hospital Cardiac Arrest Register between 1 January 1990 and 31 December 2009 who were found in bystander-witnessed ventricular fibrillation with a presumed cardiac aetiology.Interventions Bystander cardiopulmonary resuscitation (CPR) and defibrillation.Main outcome measures Survival to 1 month.Results In all, 7187 patients fulfilled the set criteria. Age, place of out-of-hospital cardiac arrest (OHCA) and gender did not change. Bystander CPR increased from 46% to 73%; 95% CI for OR 1.060 to 1.081 per year. The median delay from collapse to defibrillation increased from 12 min to 14 min (p for trend 0.0004). Early survival increased from 28% to 45% (95% CI 1.044 to 1.065) and survival to 1 month increased from 12% to 23% (95% CI 1.058 to 1.086). Strong predictors of early and late survival were a short interval from collapse to defibrillation, bystander CPR, female gender and OHCA outside the home.Conclusion In a long-term perspective in Sweden, survival to 1 month after ventricular fibrillation almost doubled. This was associated with a marked increase in bystander CPR. Strong predictors of outcome were a short delay to defibrillation, bystander CPR, female gender and place of collapse.