Prehospital factors associated with out-of-hospital cardiac arrest outcomes in a metropolitan city: a 4-year multicenter study

被引：7

作者：

Ahn, Jae Yun ^{[1
]}

Ryoo, Hyun Wook ^{[1
]}

Moon, Sungbae ^{[1
]}

Jung, Haewon ^{[1
]}

Park, Jungbae ^{[1
]}

Lee, Won Kee ^{[2
]}

Kim, Jong-Yeon ^{[3
]}

Lee, Dong Eun ^{[4
]}

Kim, Jung Ho ^{[5
]}

Lee, Sang-Hun ^{[6
]}

机构：

[1] Kyungpook Natl Univ, Kyungpook Natl Univ Hosp, Sch Med, Dept Emergency Med, Daegu, South Korea

[2] Kyungpook Natl Univ, Med Res Collaborat Ctr, Sch Med, Dept Biostat, Daegu, South Korea

[3] Kyungpook Natl Univ, Kyungpook Natl Univ Hosp, Sch Med, Dept Publ Hlth, Daegu, South Korea

[4] Kyungpook Natl Univ, Chilgok Hosp, Sch Med, Dept Emergency Med, Daegu, South Korea

[5] Yeungnam Univ, Coll Med, Dept Emergency Med, Daegu, South Korea

[6] Keimyung Univ, Dongsan Med Ctr, Dept Emergency Med, Sch Med, Daegu, South Korea

来源：

BMC EMERGENCY MEDICINE | 2023年 / 23卷 / 01期

关键词：

Out-of-hospital cardiac arrest: emergency medical services; Survival; Advanced cardiac life support; ADVANCED AIRWAY MANAGEMENT; CARDIOPULMONARY-RESUSCITATION; REGIONAL-VARIATION; ENDOTRACHEAL INTUBATION; TRACHEAL INTUBATION; CHEST COMPRESSION; SURVIVAL; COUNTRIES; INSERTION; STRATEGY;

D O I：

10.1186/s12873-023-00899-3

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background Prehospital factors play a vital role in out-of-hospital cardiac arrest (OHCA) survivability, and they vary between countries and regions. We investigated the prehospital factors associated with OHCA outcomes in a single metropolitan city in the Republic of Korea.Methods This study included adult medical OHCA patients enrolled prospectively, using data from the citywide OHCA registry for patients registered between 2018 and 2021. The primary outcome was survival to hospital discharge. Multivariable logistic regression analysis was conducted to determine the factors associated with the study population's clinical outcomes, adjusting for covariates. We performed a sensitivity analysis for clinical outcomes only for patients without prehospital return of spontaneous circulation prior to emergency medical service departure from the scene.Results In multivariable logistic regression analysis, older age (odds ratio [OR] 0.96; 95% confidence interval [CI] 0.95-0.97), endotracheal intubation (adjusted odds ratio [aOR] 0.29; 95% [CIs] 0.17-0.51), supraglottic airway (aOR 0.29; 95% CI 0.17-0.51), prehospital mechanical chest compression device use (OR 0.13; 95% CI 0.08-0.18), and longer scene time interval (OR 0.96; 95% CI 0.93-1.00) were negatively associated with survival. Shockable rhythm (OR 24.54; 95% CI 12.99-42.00), pulseless electrical activity (OR 3.11; 95% CI 1.74-5.67), and witnessed cardiac arrest (OR 1.59; 95% CI 1.07-2.38) were positively associated with survival. In the sensitivity analysis, endotracheal intubation, supraglottic airway, prehospital mechanical chest compression device use, and longer scene time intervals were associated with significantly lower survival to hospital discharge.Conclusions Regional resuscitation protocol should be revised based on the results of this study, and modifiable prehospital factors associated with lower survival of OHCA should be improved.

引用

页数：9

共 42 条

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