Trends in treated ventricular fibrillation in out-of-hospital cardiac arrest: Ischemic compared to non-ischemic heart disease
Trends in treated ventricular fibrillation in out-of-hospital cardiac arrest: Ischemic compared to non-ischemic heart disease
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DOI：
10.1016/j.resuscitation.2005.04.015
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发表时间：
2005-10-01
期刊：
影响因子：
6.5
通讯作者：
White, RD
中科院分区：
文献类型：
--
作者：
Bunch, TJ;White, RD
背景资料：在过去的十年中，由第一反应者治疗的室颤（VF）院外心脏骤停（OHCA）的发生率有所下降。由于VF OHCA主要发生在严重冠状动脉疾病的背景下，一级和二级预防策略可能是导致其下降的部分原因。然而，这样的策略可能不会有类似的影响非缺血arrest.Methods：所有的罗切斯特明尼苏达州居民谁提出了VF OHCA从1991年至2004年，由紧急医疗服务（EMS），被列入研究。根据该时间段内罗切斯特的人群计算发生率。使用Poisson回归模型测试随时间的变化。根据Mantel-Haenszel相关性检验和双尾p值报告估计趋势的显著性。结果：在研究期间，罗切斯特经EMS治疗的VF OHCA的总体发病率为10.6/100，000（95%CI 9.1-11.8）。发病率明显下降（p < 0.001）[1991-1994年：18.2/100，000（95% CI 13.4-21.9）; 1995-1999年：11.8/100，000（95% CI 10.4-17.9）; 2000-2004年：8.7/100，000（95% CI 6.0-13.0）]。VF OHCA伴缺血性心脏病的发病率也有所下降[1991-1994：13.4/100，000（95% CI 8.9-16.9）; 1995-1999年：11.1/100，000（95% CI 8.2-15.9）; 2000-2004年：5.5/100，000（95% CI 3.8-8.2），p < 0.001]。与此相反，非缺血性心脏病的VF OHCA发病率增加[1991-1994：2.1/100，000（95%CI 1.13-3.1）; 1995-1999年：2.3/100，000（95%CI 1.9-3.7）; 2000-2004年：2.9/100，000（95%CI 2.0-3.4），p < 0.001]。这一下降归因于缺血性心脏病的VF心脏骤停减少;表明针对冠状动脉疾病的治疗策略的影响。非缺血性VF OHCA的发病率相对增加，这表明需要更多的努力来减少该队列人群的死亡率。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
Background: The incidence of ventricular fibrillation (VF) out-of-hospital cardiac arrest (OHCA) treated by first responders has declined over the past decade. Since VF OHCA occurs primarily in the setting of severe coronary artery disease, primary and secondary prevention strategies may in part account for the decline. However, such strategies may not have a similar impact on non-ischemic arrest.Methods: All Rochester Minnesota residents who presented with a VF OHCA from 1991 to 2004, treated by emergency medical services (EMS), were included in the Study. Incidence rates were calculated based on the population for Rochester during the time period. Changes over time were tested using Poisson regression models. The significance of the trends was estimated according to the Mantel-Haenszel test for association, and two-tailed p-values reported.Results: The overall incidence of EMS-treated VF OHCA in Rochester during the study period was 10.6 per 100,000 (95% CI 9.1-11.8). The incidence decreased significantly (p < 0.001) over the study period [1991-1994: 18.2/100,000(95% CI 13.4-21.9); 1995-1999: 11.8/100,000 (95% CI 10.4-17.9); 2000-2004: 8.7/100,000 (95% CI 6.0-13.0)]. The incidence of VF OHCA with ischemic heart disease also declined [1991-1994: 13.4/100,000 (95% CI 8.9-16.9); 1995-1999: 11.1/100,000 (95% CI 8.2-15.9); 2000-2004: 5.5/100,000 (95% CI 3.8-8.2), p < 0.001]. In contrast, the incidence VF OHCA with non-ischemic heart disease increased [1991-1994: 2.1/100,000 (95% CI 1.13-3.1); 1995-1999: 2.3/100,000 (95% CI 1.9-3.7); 2000-2004: 2.9/100,000 (95% CI 2.0-3.4),p < 0.001].Conclusion: The incidence of VF OHCA is declining. The decline is attributable to the reduction of VF cardiac arrest with ischemic heart disease; suggesting an impact of treatment strategies targeted at coronary artery disease. The relative increasing incidence of non-ischemic VF OHCA suggests that more efforts are required to minimize mortality in this cohort population. (c) 2005 Elsevier Ireland Ltd. All rights reserved.