Association Between Emergency Medical Services Intervention Volume and Out-of-Hospital Cardiac Arrest Survival: A Propensity Score Matching Analysis

被引：1
作者：
Vincent, Thomas [1 ]
Lefebvre, Tiphaine [2 ]
Martinez, Mikael [3 ]
Debaty, Guillaume [4 ]
Noto-Campanella, Cyril [1 ]
Canon, Valentine [5 ]
Tazarourte, Karim [6 ]
Benhamed, Axel [1 ,6 ,7 ]
ReAC Investigators
机构：
[1] Ctr Hosp Univ St Etienne, Serv SAMU42 Urgences, Saint Etienne, France
[2] Reseau UrgARA, Lyon, France
[3] Ctr Hosp Forez, Serv SMUR Urgences, Serv Urgences, Montbrison, France
[4] Ctr Hosp Univ Grenoble Alpes, Serv SAMU38, Grenoble, France
[5] Univ Lille, CHU Lille, ULR 2694, METRICS Evaluat Technol Sante & Prat Med, Lille, France
[6] Hosp Civils Lyon, Ctr Hosp Univ Edouard Herriot, Serv SAMU69 Urgences, 5 Pl Arsonval, F-69437 Lyon, France
[7] Univ Laval, Ctr Rech, Dept Med Urgence, CHU Quebec, Quebec City, PQ, Canada
来源：
JOURNAL OF EMERGENCY MEDICINE | 2024年 / 67卷 / 06期
关键词：
out-of-hospital cardiac arrest; survival; neurological outcome; volume of intervention; mobile intensive care unit; EUROPEAN RESUSCITATION COUNCIL; OUTCOMES; EXPERIENCE; EXPOSURE; CARE;
D O I：
10.1016/j.jemermed.2024.06.008
中图分类号：
R4 [临床医学];
学科分类号：
1002 ; 100602 ;
摘要：
Background: Out of hospital cardiac arrest (OHCA) survival rates are very low. An association between institutional OHCA case volume and patient outcomes has been documented. However, whether this applies to pre- hospital emergency medicine services (EMS) is unknown. Objectives: To investigate the association between the volume of interventions by mobile intensive care units (MICU) and outcomes of patients experiencing an OHCA. Methods: A retrospective cohort study including adult patients with OHCA managed by medical EMS in five French centers between 2013 and 2020. Two groups were defined depending on the overall annual numbers of MICU interventions: low and high-volume MICU. Primary endpoint was 30-day survival. Secondary endpoints were prehospital return of spontaneous circulation (ROSC), ROSC at hospital admission and favorable neurological outcome. Patients were matched 1:1 using a propensity score. Conditional logistic regression was then used. Results: 2,014 adult patients (69% male, median age 68 [57-79] years) were analyzed, 50.5% (n = 1,017) were managed by low-volume MICU and 49.5% (n = 997) by high-volume MICU. Survival on day 30 was 3.6% in the low-volume group compared to 5.1% in the high-volume group. There was no significant association between MICU volume of intervention and survival on day 30 (OR = 0.92, 95%CI [0.55;1.53]), prehospital ROSC (OR = 1.01[0.78;1.3]), ROSC at hospital admission (OR = 0.92 [0.69;1.21]), or favorable neurologic prognosis on day 30 (OR = 0.92 [0.53;1.62]). (c) 2024 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC license ( http://creativecommons.org/licenses/by-nc/4.0/)
引用
收藏
页码：e533 / e543
页数：11
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