Survival rates in out-of-hospital cardiac arrest patients transported without prehospital return of spontaneous circulation: An observational cohort study

被引：81

作者：

Drennan, Ian R. ^{[1
,2
,3
]}

Lin, Steve ^{[1
,4
]}

Sidalak, Daniel E. ^{[1
]}

Morrison, Laurie J. ^{[1
,2
,4
]}

机构：

[1] St Michaels Hosp, Li Ka Shing Knowledge Inst, Rescu, Toronto, ON M5B 1W8, Canada

[2] Univ Toronto, Dept Med, Inst Med Sci, Toronto, ON, Canada

[3] York Reg Emergency Med Serv, Toronto, ON, Canada

[4] Univ Toronto, Dept Med, Div Emergency Med, Toronto, ON, Canada

来源：

RESUSCITATION | 2014年 / 85卷 / 11期

关键词：

Out-of-hospital cardiac arrest; Emergency medical services; Termination of resuscitation; Cardiac arrest; MEDICAL FUTILITY; RESUSCITATION; TERMINATION; ASSOCIATION; VALIDATION; CRITERIA; RULE;

D O I：

10.1016/j.resuscitation.2014.07.011

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Background: Some Emergency Medical Services currently use just one component of the Universal Termination of Resuscitation (TOR) Guideline, the absence of prehospital return of spontaneous circulation (ROSC), as the single criteria to terminate resuscitation, which may deny transport to potential survivors. Objective: This study aimed to report the survival to hospital discharge rate in non-traumatic, adult outof-hospital cardiac arrest (OHCA) patients transported to hospital without a prehospital ROSC. Methods: An observational study of OHCA patients without a prehospital ROSC who met the Universal TOR Guideline for transport to hospital with ongoing resuscitation. Multivariable logistic regression was used to determine the association of each variable with survival to hospital discharge. Results: Of 20,207 OHCA treated by EMS, 3374 (16.4%) did not have a prehospital ROSC but met the Universal TOR guideline for transport to hospital with ongoing resuscitation. Of these patients, 122(3.6%) survived to hospital discharge. Survival to discharge was associated with initial shockable VF/VT rhythms (OR 5.07; 95% CI 2.77-9.30), EMS-witnessed arrests (OR 3.51; 95% CI 1.73-7.15), bystander-witnessed arrests (OR 2.11; 95% CI 1.18-3.77), and public locations (OR 1.57; 95% CI 1.02-2.40). Conclusion: In OHCA patients without a prehospital ROSC who met the Universal TOR Guideline for transport with ongoing resuscitation survival rates were above the 1% futility rate. Employing only the lack of ROSC as criteria for termination of resuscitation may miss survivors after OHCA. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

引用

页码：1488 / 1493

页数：6

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