自動外部除細動器と,入院中の心停止後の生存率
Paul S Chan1, Harlan M Krumholz, John A Spertus
1Saint Luke's Mid America Heart Institute, 4401 Wornall Rd, Fifth Floor, Kansas City, MO 64111, USA. pchan@cc-pc.com
JAMA
|November 17, 2010
まとめ
自動外部除細動器 (AED) は,入院中の心停止の生存率を向上させませんでした. AEDの使用は,特に非ショックリズムにおいて,低生存率と関連していました.
科学分野:
- 心臓病学 心臓病学
- 緊急医療 緊急医療
- 医療サービス 研究 医療サービス
背景:
- 自動外部除細動器 (AED) は,病院外心停止の生存率を向上させることが証明されています.
- 病院での心停止を経験した患者に対するAEDの有効性に関するデータは限られている.
研究 の 目的:
- 病院内心停止におけるAEDの使用と生存結果の関連性を調査する.
- 心停止を経験した入院患者の生存率にAEDの導入が影響するかどうかを判断する.
主な方法:
- 一つのコホート研究では,2000年から2008年の間に心停止を経験した入院患者11,695人を対象とした.
- 病院退院までの生存率は,AEDの使用に基づいて分析され,患者と病院の要因を制御するために多変量階層的回帰を採用しました.
主要な成果:
- AEDは38.6%の症例で使用され,退院までの全生存率は18.1%でした.
- AEDの使用は,AEDの使用なし (19.3%) と比較して,全人口の生存率の低下 (16.3%) と関連していました (調整されたRR,0.85).
- 非ショックリズムでは,AEDの使用はより低い生存率 (10.4%対15.4%) と相関しており,ショックリズムでは (38.4%対39.8%) 関連性が見つかりませんでした.
結論:
- AEDの使用は,心停止を経験した入院患者の生存率の改善と関連しませんでした.
- 研究結果は,AEDは,リズムタイプに関係なく,病院内での心停止の設定では生存の利益を与えない可能性があることを示唆しています.
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