Characteristics of time and location, and grade of severity for resuscitation in Osaka

目的：根据心跳骤停的发生部位评价其预后及相关因素。设计：以人群为基础的前瞻性纵向研究。地点：大阪府(人口8,800,000)，由36个市消防和急救部门提供服务。结果：1.在1998年5月至2001年4月期间确诊的15,211例心脏骤停患者中，有14,609人进行了复苏。在2957例旁观者目击的心源性病例中，90例(3.0%)在发病后1年内存活。在383例除颤患者中，每年评估从接到电话到除颤的间隔时间。在三年的病程中，这一间隔时间显著减少(中位数分别为14.5、13.0和11.5min)，这表明报告院外逮捕数据的项目是一项有效的EMT2运动。在公共场所或工作场所的心搏骤停患者比在私人住宅中的患者更有可能被发现为室颤和存活。在1998年5月至1999年4月期间连续报告的5,047例流行性出血热病例中，147例未满16岁。在婴儿中，羟甲的年发病率高达79/10万。儿童组旁观者PR的比例高于成人组。我们推测婴儿猝死综合征可能达到41例。结论：虽然大多数院外心脏骤停发生在私人住宅，但在公共场所或工作场所发生的心脏骤停被发现为室颤和存活的机会比私人住宅高。为了建立一个系统来改善院外心脏骤停的预后，考虑到心脏骤停的位置是一个经过深思熟虑的策略是必要的。

Objective : To evaluate the outcome and the factors concerned with of out-of-hospital cardiac arrest patients according to the location of the collapse.DESIGN : Population-based, prospective longitudinal study according to the Utstein style.Setting : Osaka Prefecture (population 8, 800, 000), served by 36 municipal fire and emergency departments.RESULTS :1. Of the 15,211 cases of confirmed cardiac arrests occurring between May 1998 and April 2001, resuscitation was attempted in 14,609 subjects. Of the 2957 cases of cardiac origin and witnessed by bystanders, 90 cases (3.0%) were alive 1 year following the episode. In 383 cases of defibrillation, the interval from receipt of call to defibrillation was evaluated annually. This interval decreased significantly during the three year course (14.5, 13.0, and 11.5 min expressed by the median), suggesting that this project to report the data of out-of-hospital arrests was an effective campaign for EMT.2. Arrest patients in public or in the work place had a higher chance of being found in ventricular fibrillation and survival than those at a private residence.3. Among 5,047 consecutive cases of OHCA reported between May 1998 and April 1999, 147 cases were under 16 years of age. The annual incidence of OHCA in infants reached 79/100,000. The percentage of bystander-PR was higher in children than that in adults. We speculated that the number of sudden infant death syndrome might have reached 41 cases.CONCLUSION : Although the majority of out-of-hospital cardiac arrests occur at private residences, arrests in public or in the work place had a higher chance of being found in ventricular fibrillation and survival than those at private residences. In order to establish a system to improve the outcome of out-of-hospital cardiac arrest, a well-considered strategy considering the location of arrest is necessary.