Temporal Trends of Out-of-Hospital Cardiac Arrests Without Resuscitation Attempt by Emergency Medical Services

被引：4

作者：

Waldmann, Victor ^{[1
,2
,3
]}

Karam, Nicole ^{[1
,2
,3
]}

Gaye, Bamba ^{[2
,3
]}

Bougouin, Wulfran ^{[2
,3
,4
]}

Dumas, Florence ^{[2
,3
,5
]}

Sharifzadehgan, Ardalan ^{[1
,2
,3
]}

Narayanan, Kumar ^{[2
,6
]}

Kassim, Haoiinda ^{[2
]}

Beganton, Frankie ^{[4
]}

Jost, Daniel ^{[7
]}

Lamhaut, Lionel ^{[8
]}

Loeb, Thomas ^{[9
]}

Adnet, Frederic ^{[10
]}

Agostinucci, Jean-Marc ^{[10
]}

Deltour, Sandrine ^{[11
]}

Revaux, Francois ^{[12
]}

Ludes, Bertrand ^{[3
]}

Voicu, Sebastian ^{[13
]}

Megarbane, Bruno ^{[13
]}

Jabre, Patricia ^{[8
]}

Cariou, Alain ^{[2
,3
,14
]}

Marijon, Eloi ^{[1
,2
,3
]}

Jouven, Xavier ^{[1
,2
,3
]}

机构：

[1] Hop Europeen Georges Pompidou, Cardiol Dept, Paris, France

[2] Hop Europeen Georges Pompidou, Sudden Death Expertise Ctr, Paris Cardiovasc Res Ctr PARCC, INSERM U970, Paris, France

[3] Paris Univ, Paris, France

[4] Hop Prive Jacques Cartier, Ramsay Gen Sante, Intens Care Unit, Massy, France

[5] Cochin Hosp, Emergency Dept, Paris, France

[6] Medicover Hosp, Cardiol Dept, Hyderabad, India

[7] Paris Firefighters Brigade, Paris, France

[8] Hop Necker Enfants Malad, SAMU Paris, Paris, France

[9] SAMU 92, Garches, France

[10] SAMU 93, Bobigny, France

[11] La Pitie Salpetriere Hosp, Cerebrovasc Unit, Paris, France

[12] SAMU 94, Creteil, France

[13] Lariboisiere Hosp, Intens Care Unit, Paris, France

[14] Cochin Hosp, Intens Care Unit, Paris, France

来源：

CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES | 2021年 / 14卷 / 03期

关键词：

emergency medical services; out-of-hospital cardiac arrest; population; resuscitation; survival; PUBLIC-ACCESS DEFIBRILLATION; AMERICAN-HEART-ASSOCIATION; CARDIOPULMONARY-RESUSCITATION; BYSTANDER; SURVIVAL; REGISTRY; INTERVENTION; GUIDELINES; STATEMENT; OUTCOMES;

D O I：

10.1161/CIRCOUTCOMES.120.006626

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Significant improvements in survival from out-of-hospital cardiac arrest (OHCA) have been reported; however, these are based only on data from OHCA in whom resuscitation is initiated by emergency medical services (EMS). We aimed to assess the characteristics and temporal trends of OHCA without resuscitation attempt by EMS. Methods: Prospective population-based study between 2011 and 2016 in the Greater Paris area (6.7 million inhabitants). All cases of OHCA were included in collaboration with EMS units, 48 different hospitals, and forensic units. Results: Among 15 207 OHCA (mean age 70.7 +/- 16.9 years, 61.6% male), 5486 (36.1%) had no resuscitation attempt by EMS. Factors that were independently associated with increase in likelihood of no resuscitation attempt included: age of patients (odds ratio, 1.06 per year [95% CI, 1.05-1.06], P<0.001), female sex (odds ratio, 1.21 [95% CI, 1.10-1.32], P=0.002), OHCA at home location (odds ratio, 3.38 [95%CI, 2.86-4.01], P<0.001), and absence of bystander (odds ratio, 1.94 [95% CI, 1.74-2.16], P<0.001). Overall, the annual number of OHCA increased by 9.1% (from 2923 to 3189, P=0.028). This increase was related to an increase of the annual number of OHCA without resuscitation attempt by EMS by 26.3% (from 993 to 1253, P=0.012), while the annual number of OHCA with resuscitation attempt by EMS did not significantly change (from 1930 to 1936, P=0.416). Considering only cases with resuscitation attempt, survival rate at hospital discharge increased (from 7.3% to 9.5%, P=0.02). However, when considering all OHCA, survival improvement did not reach statistical significance (from 4.8% to 5.7%, P=0.17). Conclusions: We demonstrated an increase of the total number of OHCA related to an increase of the number of OHCA without resuscitation attempt by EMS. This increasing proportion of OHCA without resuscitation attempt attenuates improvement in survival rates achieved in EMS-treated patients.

引用

页数：11

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