Demographic and Outcome Analysis in Adult Patients with Non-Traumatic out-of-Hospital Cardiac Arrest in Central Taiwan

中臺灣地區非外傷性成人到院前心跳停止流行病學及預後分析

賴世昌(Shih-Chang Lai) ； 李肇瑞(Chao-Jui Li) ； 蕭名豪(Ming-Hau Hsiao) ； 周志中(Chu-Chung Chou) ； 張進富(Chin-Fu Chang) ； 劉慈安(Tzu-An Liu) ； 林晏任(Yan-Ren Lin)

《Journal of Emergency Medicine, Taiwan》 11卷1期 (2009/03) Pp. 1-9

摘要

Background: The aim is, among non-traumatic out-of-hospital cardiac arrest (OHCA) adult patients in central Taiwan, to present the demographic and, outcome factors associated with sustained return of spontaneous circulation (ROSC) and the relationship between different durations of in-hospital cardiopulmonary resuscitation (CPR) and prognosis.
Methods: Four hundreds and thirty-one non-traumatic OHCA patients ＞18 years were included in this retrospective study (Dec 2006~Dec 2008). Demographics and the factors that lead to sustained ROSC and those that do not lead to sustained ROSC were analyzed. Survival analyses, including the cut-off time of resuscitation, the chance of achieving sustained ROSC and the mean total duration of ROSC, were conducted relative to the duration of in-hospital CPR.
Results: Ten major etiologies that caused non-traumatic OHCA in adults were identified and cardiovascular disease (23%), infections (18.1%) and asphyxia (16.8%) were the three most common etiologies. An automated external defibrillator was used on 56.4% patients and 19.7% of them had presented with a shockable cardiac rhythm before arriving hospital. Initial cardiac rhythm (P=0.001), mode of transportation (P=0.001) and duration of in-hospital CPR (P＜0.001) were the key factors associated with achieving sustained ROSC in the emergency department. The best cut-off point for in-hospital CPR duration for patients to establish a sustained ROSC was 20 min. Most patients (51.5%) established a sustained ROSC after 11 min to 20 min of CPR and patients who achieved sustained ROSC within 10 min of CPR maintained the longest mean duration of ROSC.
Conclusions: Patients have the highest chance of achieving sustained ROSC when the CPR duration is between 11 min to 20 min and in-hospital CPR should be kept for 20 min when attempting to obtain a return of spontaneous circulation.

關鍵字

流行病學 ； 到院前心跳停止 ； 預後 ； 復甦 ； 回復自發性循環

並列摘要

Background: The aim is, among non-traumatic out-of-hospital cardiac arrest (OHCA) adult patients in central Taiwan, to present the demographic and, outcome factors associated with sustained return of spontaneous circulation (ROSC) and the relationship between different durations of in-hospital cardiopulmonary resuscitation (CPR) and prognosis.
Methods: Four hundreds and thirty-one non-traumatic OHCA patients ＞18 years were included in this retrospective study (Dec 2006~Dec 2008). Demographics and the factors that lead to sustained ROSC and those that do not lead to sustained ROSC were analyzed. Survival analyses, including the cut-off time of resuscitation, the chance of achieving sustained ROSC and the mean total duration of ROSC, were conducted relative to the duration of in-hospital CPR.
Results: Ten major etiologies that caused non-traumatic OHCA in adults were identified and cardiovascular disease (23%), infections (18.1%) and asphyxia (16.8%) were the three most common etiologies. An automated external defibrillator was used on 56.4% patients and 19.7% of them had presented with a shockable cardiac rhythm before arriving hospital. Initial cardiac rhythm (P=0.001), mode of transportation (P=0.001) and duration of in-hospital CPR (P＜0.001) were the key factors associated with achieving sustained ROSC in the emergency department. The best cut-off point for in-hospital CPR duration for patients to establish a sustained ROSC was 20 min. Most patients (51.5%) established a sustained ROSC after 11 min to 20 min of CPR and patients who achieved sustained ROSC within 10 min of CPR maintained the longest mean duration of ROSC.
Conclusions: Patients have the highest chance of achieving sustained ROSC when the CPR duration is between 11 min to 20 min and in-hospital CPR should be kept for 20 min when attempting to obtain a return of spontaneous circulation.

並列關鍵字

demographics ； out-of-hospital cardiac arrest ； outcome ； resuscitation ； return of spontaneous circulation