Association between Timing of Epinephrine Administration and Outcomes of Traumatic Out-of-Hospital Cardiac Arrest following Traffic Collisions
Association between Timing of Epinephrine Administration and Outcomes of Traumatic Out-of-Hospital Cardiac Arrest following Traffic Collisions
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DOI：
10.3390/jcm11123564
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发表时间：
2022-06-20
影响因子：
3.9
通讯作者：
Oda, Jun
中科院分区：
文献类型：
--
作者：
Hosomi, Sanae;Kitamura, Tetsuhisa;Sobue, Tomotaka;Zha, Ling;Kiyohara, Kosuke;Matsuyama, Tasuku;Oda, Jun
肾上腺素给药时机对交通碰撞后院外心脏骤停（OHCA）患者的影响尚不清楚。我们分析了2013-2019年全日本Utstein登记研究的2024例年龄≥18岁的此类患者的数据，这些患者由紧急医疗服务（EMS）人员或旁观者进行复苏，然后运送到医疗机构。从119次呼叫到肾上腺素给药的时间分为四分位数：Q1（6-21 min）、Q2（22-26 min）、Q3（27-34 min）和Q4（35-60 min）。采用多变量logistic回归分析评估肾上腺素给药时间对OHCA后1个月生存率的影响。总体而言，Q1的1个月生存率为3.2%（15/466），Q2为1.1%（5/472），Q3为1.9%（11/577），Q4为0.2%（1/509）。此外，与Q1组相比，Q4组的1个月生存率显著降低（校正比值比，0.07; 95%置信区间，0.01-0.57），并且1个月生存概率随着从EMS呼叫到肾上腺素给药的时间增加而降低（趋势p值= 0.009）。仅4例最早给予肾上腺素的患者（0.9% [4/466]）显示出良好的神经系统结局。
The effects of epinephrine administration timing on patients with out-of-hospital cardiac arrest (OHCA) following traffic collisions are unknown. We analyzed the 2013–2019 All-Japan Utstein Registry data of 2024 such patients aged ≥18 years who were resuscitated by emergency medical service (EMS) personnel or bystanders and then transported to medical institutions. Time from 119 call to epinephrine administration was classified into quartiles: Q1 (6–21 min), Q2 (22–26 min), Q3 (27–34 min), and Q4 (35–60 min). Multivariable logistic regression analysis was used to assess the effects of epinephrine administration timing on one-month survival after OHCA. Overall, the one-month survival rates were 3.2% (15/466) in Q1, 1.1% (5/472) in Q2, 1.9% (11/577) in Q3, and 0.2% (1/509) in Q4. Additionally, the one-month survival rate decreased significantly in the Q4 group (adjusted odds ratio, 0.07; 95% confidence interval, 0.01–0.57) compared with the Q1 group, and the probability of one-month survival decreased as the time from the EMS call to epinephrine administration increased (p-value for trend = 0.009). Only four patients (0.9% [4/466]) with the earliest epinephrine administration showed a good neurological outcome.
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影响因子：
3.9
作者：
Hosomi S;Kitamura T;Sobue T;Zha L;Kiyohara K;Oda J
通讯作者：
Oda J
影响因子：
16.9
作者：
Fukuda, Tatsuma;Ohashi-Fukuda, Naoko;Kukita, Ichiro
通讯作者：
Kukita, Ichiro
影响因子：
7.2
作者：
Gallo, Valentina;Egger, Matthias;Vineis, Paolo
通讯作者：
Vineis, Paolo
影响因子：
37.8
作者：
CUMMINS, RO;CHAMBERLAIN, DA;THIES, WH
通讯作者：
THIES, WH
影响因子：
6.5
作者：
Lockey, David J.;Lyon, Richard M.;Davies, Gareth E.
通讯作者：
Davies, Gareth E.