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

目的：探讨院外心脏骤停患者发生塌陷部位的转归及相关因素。设计：以人群为基础，根据Utstein风格进行前瞻性纵向研究。周边环境：大阪府（人口880万），由36个市政消防和紧急部门提供服务。结果:1。在1998年5月至2001年4月间发生的15211例确认的心脏骤停病例中，有14609人尝试过复苏。在2957例心脏源性并有旁观者目击的病例中，90例（3.0%）在发病后1年仍存活。在383例除颤病例中，每年评估从接到电话到除颤的间隔时间。这个时间间隔在三年的过程中显著减少（14.5、13.0和11.5分钟，中位数表示），这表明这个报告院外逮捕数据的项目是emt的一个有效活动。2 .在公共场所或工作场所的心脏骤停患者比在私人住所的患者有更高的机会发现心室颤动和生存。在1998年5月至1999年4月期间报告的连续5,047例OHCA病例中，有147例患者年龄在16岁以下。婴儿中OHCA的年发病率达到79/10万。旁观者pr在儿童中的比例高于成人。我们推测婴儿猝死综合征的数量可能达到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的心脏骤停发现心室颤动和生存的机会高于私人住宅。为了建立一个系统来改善院外心脏骤停的结果，考虑到骤停的位置，一个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.