Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin
Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin
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DOI：
10.1016/j.resuscitation.2006.06.040
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发表时间：
2007-02-01
期刊：
影响因子：
6.5
通讯作者：
White, Roger D.
中科院分区：
文献类型：
--
作者：
Hess, Erik P.;Campbell, Ronna L.;White, Roger D.
简介：经历院外心脏骤停（OHCA）的大多数受害者具有室颤（VF）作为呈现节律，并且被认为具有其骤停的心脏病因。在过去的十年中，VF OHCA的发病率有所下降。本研究的目的是描述的流行病学OHCA的非心源性在奥姆斯特德县MN，并确定已发生的趋势，随着时间的推移。方法：所有居民的创伤OHCA从1995年至2005年进行了分析。根据Utstein方法前瞻性收集OHCA数据。心脏骤停被分类为心脏或非心脏的起源和病因确定的基础上尸检报告，电子病历，和/或紧急医疗服务reports.Results：在研究期间，414 OHCA被确定，其中90（21.7%）被归类为非心脏。平均年龄为61.5 ± 19.7岁。反应时间为7.73 +/- 2.9 min，40例（44.4%）为旁观者目击。68人（75.6%）在家中被捕，13人（14.4%）在公共场所被捕，9人（10%）在其他地点被捕。17例（18.9%）进行了旁观者CPR。表现为室颤2例（2.2%），阵发性心动过速54例（60%），心搏停止34例（37.8%）。8例（8.9%）患者存活至出院。呼吸衰竭（35.6%）、不明原因（15.6%）和肺栓塞（13.3%）是最常见的病因。在三个连续的时间段（1995-1999年，2000-2002年，2003-2005年），由于非心脏原因的逮捕的平均百分比分别为9.4%，20.1%和37.7%.Conclusions：在研究期间，21.7%的OHCAs是非心脏的起源。PEA是最常见的心律失常，呼吸衰竭是最常见的病因。8.9%的患者存活。室颤停搏次数的减少可能是院外环境中观察到的非心源性OHCA比例增加的一个促成因素。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
Introduction: The majority of victims who experience out-of-hospital cardiac arrest (OHCA) have ventricular fibrillation (VF) as the presenting rhythm and are thought to have a cardiac etiology for their arrest. Over the past decade, the incidence of VF OHCA has declined. The aims of this study were to describe the epidemiology of OHCA of non-cardiac origin in Olmsted County MN and to determine the trends that have occurred over time.Methods: All residents with a traumatic OHCA from 1995 to 2005 were included for analysis. OHCA data were collected prospectively according to the Utstein method. Cardiac arrests were classified as cardiac or non-cardiac in origin and the etiology determined based on autopsy reports, electronic medical records, and/or emergency medical services reports.Results: During the study period, 414 OHCAs were identified, 90 (21.7%) of which were classified as non-cardiac. Mean age was 61.5 +/- 19.7 years. Response time was 7.73 +/- 2.9 min, and 40 (44.4%) were bystander-witnessed. Sixty-eight (75.6%) arrests occurred at home, 13 (14.4%) in a public place, and 9 (10%) in other locations. Bystander CPR was performed in 17 (18.9%) cases. The presenting rhythm was VF in 2 (2.2%) cases, PEA in 54 (60%), and asystole in 34 (37.8%). Eight (8.9%) patients survived to hospital discharge. Respiratory failure (35.6%), unknown (15.6%), and pulmonary embolism (13.3%) were the most common etiologies. The mean percentage of arrests due to a non-cardiac cause in three sequential time-periods (1995-1999, 2000-2002, 2003-2005) was 9.4%, 20.1% and 37.7%, respectively.Conclusions: Over the study period, 21.7% of OHCAs were non-cardiac in origin. PEA was the most common presenting rhythm and respiratory failure the most common etiology. 8.9% of patients survived. The decreasing number of VF arrests may be a contributing factor to the increasing proportion of OHCAs of non-cardiac etiology observed in the out-of-hospital setting. (c) 2006 Elsevier Ireland Ltd. All rights reserved.