Recruitments of trained citizen volunteering for conventional cardiopulmonary resuscitation are necessary to improve the outcome after out-of-hospital cardiac arrests in remote time-distance area: A nationwide population-based study

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• 作者：Yutaka Takei^a ; ^b ; ¹ ; ^{y-takei@hs.hirokoku-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Takahisa Kamikura^a ; ¹ ; ^{kamitaka911@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Taiki Nishi^a ; ^{ntaiki24@yahoo.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Tetsuo Maeda^a ; ^{tetsumae@med.kanazawa-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Satoru Sakagami^c ; ^{afib@kinbyou.hosp.go.jp" class="auth_mail" title="E-mail the corresponding author} ; Minoru Kubo^d ; ^{min-kubo3e@ipch.jp" class="auth_mail" title="E-mail the corresponding author} ; Hideo Inaba^a ; ^{hidinaba@med.kanazawa-u.ac.jp" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Conventional cardiopulmonary resuscitation ; Dispatcher-assisted ; Bystander ; Out-of-hospital cardiac arrest ; Survival
• 刊名：Resuscitation
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：105
• 期：Complete
• 页码：100-108
• 全文大小：1852 K

文摘

To compare the factors associated with survival after out-of-hospital cardiac arrests (OHCAs) among three time-distance areas (defined as interquartile range of time for emergency medical services response to patient's side).

Methods

From a nationwide, prospectively collected data on 716,608 OHCAs between 2007 and 2012, this study analyzed 193,914 bystander-witnessed OHCAs without pre-hospital physician involvement.

Results

Overall neurologically favourable 1-month survival rates were 7.4%, 4.1% and 1.7% for close, intermediate and remote areas, respectively. We classified BCPR by type (compression-only vs. conventional) and by dispatcher-assisted CPR (DA-CPR) (with vs. without); the effects on time-distance area survival were analyzed by BCPR classification. Association of each BCPR classification with survival was affected by time-distance area and arrest aetiology (p < 0.05). The survival rates in the remote area were much higher with conventional BCPR than with compression-only BCPR (odds ratio; 95% confidence interval, 1.26; 1.05–1.51) and with BCPR without DA-CPR than with BCPR with DA-CPR (1.54; 1.29–1.82). Accordingly, we classified BCPR into five groups (no BCPR, compression-only with DA-CPR, conventional with DA-CPR, compression-only without DA-CPR, and conventional without DA-CPR) and analyzed for associations with survival, both cardiac and non-cardiac related, in each time-distance area by multivariate logistic regression analysis. In the remote area, conventional BCPR without DA-CPR significantly improved survival after OHCAs of cardiac aetiology, compared with all the other BCPR groups. Other correctable factors associated with survival were short collapse-to-call and call-to-first CPR intervals.

Conclusion

Every effort to recruit trained citizens initiating conventional BCPR should be made in remote time-distance areas.