Epidemiology and outcomes of out-of-hospital cardiac arrest in Rochester, New York

被引:70
作者
Fairbanks, Rollin J.
Shah, Manish N.
Lerner, E. Brooke
Ilangovan, Kumar
Pennington, Elliot C.
Schneider, Sandra M.
机构
[1] Univ Rochester, Sch Med & Dent, Dept Emergency Med, Rochester, NY 14642 USA
[2] Univ Rochester, Sch Med & Dent, Dept Community & Prevent Med, Rochester, NY 14642 USA
[3] Loyola Univ, Chicago Stritch Sch Med, Maywood, IL 60153 USA
[4] Univ Missouri, Sch Med, Columbia, MO 65211 USA
关键词
advanced life support (ALS); cardiac arrest; cardiopulmonary resuscitation; emergency medical services; heart arrest; outcome;
D O I
10.1016/j.resuscitation.2006.06.135
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To characterize out-of-hospital cardiac arrest (OHCA) and factors that affect survival in a medium sized city that uses system status management for dispatch. Methods: A retrospective cohort study of all adult OHCA patients treated by EMS between 1998 and 2001 was conducted using Utstein definitions. The primary endpoint was 1-year survival. Results: Of the 1177 patients who experienced OHCA during the study period, 539 (46%) met inclusion criteria. Age ranged from 18 to 98 years (median 67). The median call-response interval was 5 min (range 0-21), and 93% were 9 min or less. There was no significant difference in the median call-response intervals between call location zip (Post) codes (p = 0.07). Twenty percent of experienced ROSC (95% Cl 17-23), 7% survived more than 30 days (95% Cl 5-9%), and 5% survived to 1 year (95% Cl 3-7%). In bivariate analysis, first rhythm and bystander CPR affected survival to 1 year. There was no significant difference in survival between mate (4%) and female (7%), black (4%) and white (6%), or witnessed (7%) and unwitnessed arrest (4%). Logistic regression identified younger age, CPR initiated by bystander (19%) or first responder (41 %), and presenting rhythm of VF/VT (32%) as factors associated with survival to 1 year. Conclusions: This study finds a 5% survival to 1 year among OHCA patients in Rochester, NY. A presenting rhythm of VF/VT and bystander CPR were associated with increased survival. (c) 2006 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:415 / 424
页数:10
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