Out-of-hospital cardiac arrest survival improving over time: Results from the Resuscitation Outcomes Consortium (ROC).
Out-of-hospital cardiac arrest survival improving over time: Results from the Resuscitation Outcomes Consortium (ROC).
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DOI：
10.1016/j.resuscitation.2015.02.003
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发表时间：
2015-06
期刊：
影响因子：
6.5
通讯作者：
Resuscitation Outcomes Consortium Investigators
中科院分区：
文献类型：
--
作者：
Daya MR;Schmicker RH;Zive DM;Rea TD;Nichol G;Buick JE;Brooks S;Christenson J;MacPhee R;Craig A;Rittenberger JC;Davis DP;May S;Wigginton J;Wang H;Resuscitation Outcomes Consortium Investigators
院外心脏骤停（OHCA）仍然是死亡的主要原因，2010年的一项荟萃分析得出结论，几十年来结局没有改善。然而，指南已经改变，强调CPR质量，最大限度地减少中断和标准化的复苏后护理。我们试图评估参与复苏结局联盟（ROC）心脏骤停登记（Epistry）和随机临床试验（RCT）的机构中OHCA结局是否随时间推移而改善。对来自10个ROC研究中心的139个EMS机构的47，148例接受EMS治疗的OHCA病例进行的观察性队列研究，这些病例在2006年1月1日至2010年12月31日期间至少参加了一项RCT。我们回顾了EMS治疗的OHCA随时间推移的患者、场景、事件特征和结局，包括初始节律为无脉性室性心动过速或室颤（VT/VF）的亚组。平均缓解间期、中位年龄和男性比例随时间推移保持相似。2006年至2010年期间，OHCA治疗组（从8.2%增加至10.4%）、VT/VF亚组（21.4%至29.3%）和旁观者见证VT/VF亚组（23.5%至30.3%）的未校正出院生存率增加。与2006年相比，2010年治疗病例（OR = 1.72; 95% CI 1.53，1.94）、VT/VF病例（OR = 1.69; 95% CI 1.45，1.98）和旁观者见证的VT/VF病例（OR = 1.65; 95% CI 1.36，2.00）的校正出院生存率显著升高。每个亚组的趋势检验均具有显著性（p <0.001）。2006年至2010年期间，ROC范围内的生存率显著增加。需要进行更多的研究，以确定与这种改善相关的具体因素。
Out-of-hospital cardiac arrest (OHCA) remains a leading cause of death and a 2010 meta-analysis concluded that outcomes have not improved over several decades. However, guidelines have changed to emphasize CPR quality, minimization of interruptions, and standardized post-resuscitation care. We sought to evaluate whether OHCA outcomes have improved over time among agencies participating in the Resuscitation Outcomes Consortium (ROC) cardiac arrest registry (Epistry) and randomized clinical trials (RCTs). Observational cohort study of 47,148 EMS-treated OHCA cases in Epistry from 139 EMS agencies at 10 ROC sites that participated in at least one RCT between 1/1/2006 and 12/31/2010. We reviewed patient, scene, event characteristics, and outcomes of EMS-treated OHCA over time, including subgroups with initial rhythm of pulseless ventricular tachycardia or ventricular fibrillation (VT/VF). Mean response interval, median age and male proportion remained similar over time. Unadjusted survival to discharge increased between 2006 and 2010 for treated OHCA (from 8.2% to 10.4%), as well as for subgroups of VT/VF (21.4% to 29.3%) and bystander witnessed VT/VF (23.5% to 30.3%). Compared with 2006, adjusted survival to discharge was significantly higher in 2010 for treated cases (OR = 1.72; 95% CI 1.53, 1.94), VT/VF cases (OR = 1.69; 95% CI 1.45, 1.98) and bystander witnessed VT/VF cases (OR = 1.65; 95% CI 1.36, 2.00). Tests for trend in each subgroup were significant (p < 0.001). ROC-wide survival increased significantly between 2006 and 2010. Additional research efforts are warranted to identify specific factors associated with this improvement.
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影响因子：
37.8
作者：
Cheskes S;Schmicker RH;Christenson J;Salcido DD;Rea T;Powell J;Edelson DP;Sell R;May S;Menegazzi JJ;Van Ottingham L;Olsufka M;Pennington S;Simonini J;Berg RA;Stiell I;Idris A;Bigham B;Morrison L;Resuscitation Outcomes Consortium (ROC) Investigators
通讯作者：
Resuscitation Outcomes Consortium (ROC) Investigators
影响因子：
6.5
作者：
Cheskes, Sheldon;Schmicker, Robert H.;Christenson, Jim
通讯作者：
Christenson, Jim
影响因子：
4.5
作者：
Eckmanns, Tim;Bessert, Jan;Rueden, Henning
通讯作者：
Rueden, Henning
影响因子：
6.5
作者：
Bigham, Blair L.;Koprowicz, Kent;Morrison, Laurie J.
通讯作者：
Morrison, Laurie J.
影响因子：
37.8
作者：
Rea, Thomas D.;Helbock, Michael;Eisenberg, Mickey
通讯作者：
Eisenberg, Mickey