Long-term changes in the incidence of out-of-hospital ventricular fibrillation

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• 作者：Taneli V&#xe4 ; yrynen^a ; ^{taneli.vayrynen@vshp.fi"" rel=""nofollow} ; James Boyd^b ; Marko Sorsa^c ; Teuvo M&#xe4 ; &#xe4 ; tt&#xe4 ; ^b ; Markku Kuisma^d
• 关键词：Out-of-hospital cardiac arrest ; Ventricular fibrillation ; Incidence
• 刊名：Resuscitation
• 出版年：2011
• 出版时间：July 2011
• 年：2011
• 卷：82
• 期：7
• 页码：825-829
• 全文大小：186 K

文摘

Aim of the study

To report the long-term changes in the incidence of out-of-hospital ventricular fibrillation (VF), and also to report concurrent changes in the possible explanatory factors for the change.

Methods

This was a retrospective observational study. All bystander-witnessed out-of-hospital cardiac arrests (with a known initial rhythm) in Helsinki, Finland during 1.1.1994–31.12.2007 were included in the study. High (years 1994–1996) and low (2002–2004) incidence periods for VF were defined and compared.

Results

There were 3131 bystander-witnessed out-of-hospital cardiac arrests of which 3118 (99.6 % ) had a known initial rhythm. During 2000–2007 the annual incidence of bystander witnessed ventricular fibrillation (VF) was 11.6 (95 % CI 9.7–13.5) per 100,000 inhabitants. In 1994–1996 VF was 1.8 times more likely than in 2002–2004, after adjustment for several patient related factors and EMS related factors. Arrests with cardiac aetiology became less common, as 54.8 % arrests had a cardiac cause in 1994–1996 compared to 45.2 % in 2002–2004 (p < 0.001). Of cardiac arrests with cardiac aetiology, 60.6 % presented with VF in 1994–1996 compared to 45.7 % in 2002–2004 (p < 0.001). There were major changes in the possible explanatory factors during the study period.

Conclusion

The decline in the incidence of out-of-hospital VF seems to have ended, and the annual incidence of VF has stabilised to 11.6 (95 % CI 9.7–13.5) per 100,000 inhabitants. During the period of lower incidence of VF, cardiac aetiology caused fewer arrests, and these arrests did not present with VF as often as previously.