- 作者：Louise Martinell ; Malena Larsson ; Angela Bå ; ng ; Thomas Karlsson ; Jonny Lindqvist ; Ann-Britt Thoré ; n ; Johan Herlitz
- 刊名：The American Journal of Emergency Medicine
- 出版年：2010
- 出版时间：June 2010
- 年：2010
- 卷：28
- 期：5
- 页码：543-551
- 全文大小：409 K
BackgroundKnowledge of the epidemiology of postresuscitation care is insufficient. We describe the epidemiology of postresuscitation care in a community from a 26-year perspective, focusing on incidence, patient characteristics, survival, and estimated cerebral function in relation to intensified postresuscitation care and initial arrhythmia.Methods
The study included patients with out-of-hospital cardiac arrest (OHCA) who were brought alive to a hospital ward in Göteborg, Sweden, between 1980 and 2006. Two periods (1980-2002 and 2003-2006) were compared.
Results
In all, 1603 patients were included. For age, sex, and history, no significant differences between the 2 periods were seen. There was a significant multiple increase in bystander cardiopulmonary resuscitation, the use of coronary angiography, coronary revascularization, and therapeutic hypothermia. The number of patients found in ventricular fibrillation (VF) decreased (P = .011).
For all patients, 1-year survival did not change significantly (27 % vs 32 % ; P = .14). Among patients found in VF, an increase in 1-year survival was found (37 % vs 57 % ; P < .0001), whereas no significant change was seen in nonshockable rhythm (10 % vs 7 % ; P = .38). Survivors to discharge displaying low cerebral function (ie, cerebral performance categories score ≥3) decreased from 28 % to 6 % (P = .0006) among all patients.
Conclusion
After the introduction of a more intensified postresuscitation care, there was no overall improvement in survival but signs of an improved cerebral function among survivors. There was a marked increase in survival among patients found in a shockable rhythm but not among those found in a nonshockable rhythm.