Incidence of out-of-hospital cardiac arrest
Incidence of out-of-hospital cardiac arrest
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DOI：
10.1016/j.amjcard.2004.03.002
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发表时间：
2004-06-15
影响因子：
2.8
通讯作者：
Siscovick, DS
中科院分区：
文献类型：
--
作者：
Rea, TD;Pearce, RM;Siscovick, DS
对院外原发性心脏骤停(CA)发生率的估计通常仅依赖紧急医疗服务或死亡证明记录，而没有调查临床亚组的发生率。在临床定义的群体中，使用系统的方法来确定CA的发病率，对CA的总体和时间模式进行调查。对发病率的估计是根据1986年至1994年一项大型健康计划中以人群为基础的病例对照研究得出的。研究对象为年龄在50岁到79岁之间的CA患者(n=1,275)。采用分层随机抽样的方法，对未患CA的人群(n=2,323)进行不同临床特征的高危人群估计。泊松回归被用来估计总发病率和3年期间(1986-1988年、1989-1991年和1992-1994年)。总体CA发病率为1.89/1000研究对象年，在临床亚组之间差异高达30倍。例如，有任何临床公认心脏病的受试者的发病率为5.98/1000研究对象年，而没有心脏病的受试者为0.82/1000研究对象年。在心脏病亚组中，既往心肌梗死患者的发病率为13.69/1000主题年，心力衰竭患者的发病率为21.87/1000主题年。从最初到最后一段时间，风险降低了20%，与没有临床心脏病的人(12%)相比，有临床心脏病的人(25%)的下降幅度更大。因此，CA的发病率在不同的临床组之间差别很大。这些结果提供了关于临床定义的亚组的绝对风险和人群归因风险的见解，这些信息可能有助于旨在降低CA死亡率的策略。(C)2004年，由Excerpta Medica，Inc.
Estimates of the incidence of out-of-hospital primary cardiac arrest (CA) have typically relied solely upon emergency medical service or death certificate records and have not investigated incidence in clinical subgroups. Overall and temporal patterns of CA incidence were investigated in clinically defined groups using systematic methods to ascertain CA. Estimates of incidence were derived from a population-based case-control study in a large health plan from 1986 to 1994. Subjects were enrollees aged 50 to 79 years who had had CA (n = 1,275). A stratified random sample of enrollees who had not had CA was used to estimate the population at risk with various clinical characteristics (n = 2,323). Poisson's regression was used to estimate incidence overall and for 3-year time periods (1986 to 1988, 1989 to 1991, and 1992 to 1994). The overall CA incidence was 1.89/1,000 subject-years and varied up to 30-fold across clinical subgroups. For example, incidence was 5.98/1,000 subject-years in subjects with any clinically recognized heart disease compared with 0.82/1,000 subject-years in subjects without heart disease. In subgroups with heart disease, incidence was 13.69/1,000 subject-years in subjects with prior myocardial infarction and 21.87/1,000 subject-years in subjects with heart failure. Risk decreased by 20% from the initial to the final time period, with a greater decrease observed in those with (25%) compared with those without (12%) clinical heart disease. Thus, CA incidence varied considerably across clinical groups. The results provide insights regarding absolute and population-attributable risk in clinically defined subgroups, information that may aid strategies aimed at reducing mortality from CA. (C) 2004 by Excerpta Medica, Inc.