Dispatcher-assisted bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest
Dispatcher-assisted bystander cardiopulmonary resuscitation and survival in out-of-hospital cardiac arrest
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DOI：
10.1016/j.ijcard.2018.04.067
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发表时间：
2018-08-15
影响因子：
3.5
通讯作者：
Nagata, Takashi
中科院分区：
文献类型：
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作者：
Hagihara, Akihito;Onozuka, Daisuke;Nagata, Takashi
引言：旁观者心肺复苏（CPR）对院外心脏骤停（OHCA）患者的生存至关重要。然而，目前还不清楚是否有或没有调度员协助的旁观者心肺复苏术更有效或为什么。因此，我们评估了调度员辅助的旁观者心肺复苏术（与旁观者心肺复苏术没有调度员援助）和OHCA.Methods患者的生存率之间的关联：这是一项回顾性，非随机，观察性研究，使用国家登记数据的所有OHCAs。我们做了倾向性分析。心源性OHCA患者年龄在18-100岁之间，于2005年至2014年期间在日本接受了旁观者胸外按压。结果的措施是旁观者抢救呼吸，返回自主循环（ROSC）之前到达医院，和生存和脑功能分类（CPC）1或2在1个月后events.Results：在研究期间，1,176,351 OHCA发生，87,400例符合纳入标准。在倾向匹配的患者中，在完全调整的模型中观察到调度员辅助的旁观者心肺复苏与结局指标之间呈负相关[ROSC的比值比（OR）（95%CI）= 0.87（0.78-0.97），P < 0.05; 1个月生存期OR（95%CI）= 0.81（0.65-1.00），P < 0.05; CPC 1或2的OR（95%CI）= 0.64（0.43-0.93），P < 0.05]。调度员辅助的旁观者CPR的生存率OR趋于下降的紧急医疗服务响应时间increased.Conclusions：调度员辅助的旁观者CPR与调度员的援助比没有调度员援助的生存效益。低质量被假设为受益减少的原因。(c)2018爱思唯尔B. V.保留所有权利。
Introduction: Bystander cardiopulmonary resuscitation (CPR) is critical to the survival of patients with out-of-hospital cardiac arrest (OHCA). However, it is unknown whether bystander CPR with or without dispatcher assistance is more effective or why. Thus, we evaluated the association between dispatcher-assisted bystander CPR (vs. bystander CPR without dispatcher assistance) and survival of patients with OHCA.Methods: This is a retrospective, nonrandomized, observational study using national registry data for all OHCAs. We performed a propensity analysis. Patients with OHCA of cardiac origin were 18-100 years of age and received bystander chest compression in Japan between 2005 and 2014. Outcome measures were bystander rescue breathing, return of spontaneous circulation (ROSC) before hospital arrival, and survival and Cerebral Performance Category (CPC) 1 or 2 at 1 month after the event.Results: During the study period, 1,176,351 OHCAs occurred, and 87,400 cases met the inclusion criteria. Among propensity-matched patients, a negative association was observed between dispatcher-assisted bystander CPR and outcome measures in a fully-adjusted model [odds ratio (OR) (95% CI) for ROSC = 0.87 (0.78-0.97), P < 0.05; OR (95% CI) for 1-month survival = 0.81 (0.65-1.00), P < 0.05; OR (95% CI) for CPC 1 or 2 = 0.64 (0.43-0.93), P < 0.05]. OR of survival for dispatcher-assisted bystander CPR tended to decrease as the emergency medical services response time increased.Conclusions: Survival benefit was less for dispatcher-assisted bystander CPR with dispatcher assistance than without dispatcher assistance. Low quality is hypothesized to be the cause of the reduced benefit. (c) 2018 Elsevier B.V. All rights reserved.