Nationwide Public-Access Defibrillation in Japan.
Nationwide Public-Access Defibrillation in Japan.
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DOI：
10.1056/nejmoa0906644
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发表时间：
2010-03-18
影响因子：
158.5
通讯作者：
Hiraide, Atsushi
中科院分区：
文献类型：
--
作者：
Kitamura, Tetsuhisa;Iwami, Taku;Hiraide, Atsushi
背景：目前尚不清楚在公共场所推广自动体外除颤器能否提高院外心脏骤停患者的存活率。方法：从2005年1月1日至2007年12月31日，我们进行了一项基于人群的前瞻性观察性研究，研究对象包括日本各地连续出现院外心脏骤停并由急救人员尝试复苏的患者。我们评估了在全国范围内推广公共途径的AEDs对院外心脏骤停后存活率的影响。主要的结果衡量标准是1个月的存活率和最小的神经损伤。结果：共有312,319名有院外心脏骤停的成年人进入研究；其中12,631名患者有室颤，并有心源性骤停，旁观者目睹了这一点。在这些患者中，462例(3.7%)由非专业人士使用公共AEDs进行电击，随着公共AEDs数量的增加，这一比例从1.2%上升到6.2%(P
Background: It is unclear whether dissemination of automated external defibrillators (AEDs) in public places can improve the rate of survival among patients who have had an out-of-hospital cardiac arrest.Methods: From January 1, 2005, through December 31, 2007, we conducted a prospective, population-based, observational study involving consecutive patients across Japan who had an out-of-hospital cardiac arrest and in whom resuscitation was attempted by emergency responders. We evaluated the effect of nationwide dissemination of public-access AEDs on the rate of survival after an out-of-hospital cardiac arrest. The primary outcome measure was the 1-month rate of survival with minimal neurologic impairment. A multivariate logistic-regression analysis was performed to assess factors associated with a good neurologic outcome.Results: A total of 312,319 adults who had an out-of-hospital cardiac arrest were included in the study; 12,631 of these patients had ventricular fibrillation and had an arrest that was of cardiac origin and that was witnessed by bystanders. In 462 of these patients (3.7%), shocks were administered by laypersons with the use of public-access AEDs, and the proportion increased, from 1.2% to 6.2%, as the number of public-access AEDs increased (P