One-year survival after out-of-hospital cardiac arrest in Bonn city: Outcome report according to the 'Utstein style'
One-year survival after out-of-hospital cardiac arrest in Bonn city: Outcome report according to the 'Utstein style'
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DOI：
10.1016/s0300-9572(96)01022-2
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发表时间：
1997-01-01
期刊：
影响因子：
6.5
通讯作者：
Schuttler, J
中科院分区：
文献类型：
--
作者：
Fischer, M;Fischer, NJ;Schuttler, J
院前心脏骤停后的结果在中型城市社区波恩的EMS系统中进行检查，并按照Utstein风格呈现。这些数据是从1989年1月1日到1992年12月31日由为24万居民服务的波恩-北部肌萎缩侧索硬化症单位收集的。排除56例非心脏病因性心脏骤停患者；464例心脏骤停后复苏(心肺复苏率：每年48.33/10万人)。无人目击坍塌178例，旁观者目击214例，急救人员目击72例。出院率和1年生存率分别为7.3%(4.5%)、22.9%(15.9%)和16.7%(11.1%)。34例患者出院时无神经功能缺陷(脑功能1级：CPC 1)，2 2例和9例分别为CPC 2和CPC 3。9名患者在出院时处于昏迷状态(CPC 4)，并一直保持这种状态直到死亡。在50名1年幸存者中，35名没有神经功能障碍，8名患者在复苏后1年时出现轻度(CPC 2)和5名重度(CPC 3)脑功能障碍，最后，2名患者昏迷超过1年。Utstein模板建议选择旁观者目睹崩溃后在VF中发现的患者。在我们的队列中，有118名患者符合这些标准。其中41例(35%)可出院，28例(24%)存活1年以上。将我们的数据与其他社区的双响应EMS系统的数据进行比较，发现在中等规模的城市和郊区社区，可以实现最高的放电率。我们的研究表明，生存取决于短时间的反应间隔和生命支持，这些将由训练有素的急救技术人员、护理人员和医生进行。版权所有(C)1997爱思唯尔科学爱尔兰有限公司。
Outcome after prehospital cardiac arrest was examined in the EMS system of Bonn, a midsized urban community, and presented according to the Utstein style. The data were collected from January ist, 1989 to December 31st, 1992 by the Bonn-north ALS unit, which serves 240 000 residents. Fifty-six patients suffered from cardiac arrest of non-cardiac aetiology and were excluded; 464 patients were resuscitated after cardiac arrest of presumed cardiac aetiology (incidence of CPR attempts: 48.33 per year/100 000 population). The collapse was unwitnessed, bystander witnessed or EMS personnel witnessed in 178, 214 or 72 patients, respectively. In these subgroups discharge rates and 1-year survival accounted for 7.3% (4.5%), 22.9% (15.9%) and 16.7% (11.1%), respectively. Thirty-four patients were discharged without neurological deficits (cerebral performance category 1: CPC 1), 22 and nine patients scored CPC 2 or CPC 3, respectively. Nine patients were comatose (CPC 4) when they were discharged and remained in this state until they died. Of the 50 1-year survivors 35 lived without neurological deficit, eight demonstrated mild (CPC 2) and five severe (CPC 3) cerebral disability at 1-year after resuscitation, and, finally, two patients remained comatose for more than 1 year. The Utstein template recommends the selection of patients who were found in VF after bystander witnessed collapse. In our cohort 118 patients met these criteria. Of them 41 (35%) could be discharged from hospital and 28 (24%) lived more than 1 year. The comparison of our data with those from double-response EMS systems of other communities revealed that, in midsized urban and suburban communities the highest discharging rates could be achieved. Our study demonstrated that survival depends crucially on short response intervals and life support which will be performed by well-trained emergency technicians, paramedics and physicians. Copyright (C) 1997 Elsevier Science Ireland Ltd.