突然心脏骤停的时间趋势:25年的紧急医疗服务视角
Thomas D Rea1, Mickey S Eisenberg, Linda J Becker
1Department of Medicine, University of Washington, Seattle, USA. rea123@u.washington.edu
Circulation
|May 21, 2003
概括
由于因素的平衡,非医院心脏骤停 (OHCA) 的生存率保持稳定. 紧急医疗服务 (EMS) 计划有助于抵消影响OHCA生存的患者特征的负面趋势.
科学领域:
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
- 心脏病学 心脏病学
背景情况:
- 对非医院心脏骤停 (OHCA) 存活率和预后因素的时间趋势的理解有限.
- 假设随着时间的推移,不断演变的有益和不利因素会影响OHCA生存模式.
研究的目的:
- 调查EMS治疗的OHCA患者的生存和预后因素的时间趋势.
- 评估"命运"因素 (患者相关) 和"计划"因素 (EMS提供的护理) 对OHCA生存的影响.
主要方法:
- 对12591名接受EMS治疗的成年OHCA患者 (1977-2001) 的基于人口的队列研究.
- 分析分为五年期和连续四年期.
- 检查了"命运"因素 (例如年龄) 和"计划"因素 (例如调度器辅助心肺复苏,除) 的变化.
主要成果:
- 整体OHCA存活率没有显著的时间变化 (OR=0.98).
- 目击室动 (VF) 的生存率有所改善 (OR=1.05).
- 当控制"命运"因素时,随着时间的推移生存率增加 (OR=1.08);控制"计划"因素显示生存率下降 (OR=0.95).
结论:
- 静态的时间生存模式是由预后因素的动态平衡造成的.
- 由EMS实施的计划有效抵消了"命运"因素的不利时间趋势,稳定了OHCA的生存率.
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