Survival and Neurologic Outcome After Out-of-hospital Cardiac Arrest. Results of the Andalusian Out-of-hospital Cardiopulmonary Arrest Registry

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• 作者：Fernando Rosell Ortiz^a ; ^b ; ^{frosell@al.epes.es" class="auth_mail" title="E-mail the corresponding author} ; Francisco Mellado Vergel^c ; Juan Bautista Ló ; pez Messa^d ; Patricia Ferná ; ndez Valle^a ; Marí ; a M. Ruiz Montero^a ; ^b ; Manuela Martí ; nez Lara^a ; ^b ; Santiago Vergara Pé ; rez^a ; ^b ; Itziar Vivar Dí ; az^a ; ^b ; Auxiliadora Caballero Garcí ; a^b ; Á ; ngel Garcí ; a Alcá ; ntara^e ; Javier Garcí ; a del Á ; guila^a ; ^b
• 关键词：Out-of-hospital cardiopulmonary arrest ; Sudden cardiac death ; Emergency services ; Survival ; Neurologic outcome
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：69
• 期：5
• 页码：494-500
• 全文大小：279 K

文摘

There is a paucity of data on prehospital cardiac arrest in Spain. Our aim was to describe the incidence, patient characteristics, and outcomes of out-of-hospital emergency care for this event.

Methods

We conducted a retrospective analysis of a prospective registry of cardiopulmonary arrest handled by an out-of-hospital emergency service between January 2008 and December 2012. The registry included all patients considered to have a cardiac etiology as the cause of arrest, with a descriptive analysis performed of general patient characteristics and factors associated with good neurologic outcome at hospital discharge.

Results

A total of 4072 patients were included, with an estimated incidence of 14.6 events per 100 000 inhabitants and year; 72.6% were men. The mean age was 62.0 ± 15.8 years, 58.6% of cases occurred in the home, 25% of patients had initial defibrillable rhythm, 28.8% of patients arrived with a pulse at the hospital (58.3% of the group with defibrillable rhythm), and 10.2% were discharged with good neurologic outcome. The variables associated with this recovery were: witnessed arrest (P = .04), arrest witnessed by emergency team (P = .005), previous life support (P = .04), initial defibrillable rhythm (P = .0001), and performance of a coronary interventional procedure (P = .0001).

Conclusions

More than half the cases of sudden cardiac arrest occur at home, and the population was found to be relatively young. Although recovery was satisfactory in 1 out of every 10 patients, there is a need for improvement in the phase prior to emergency team arrival. Coronary interventional procedures had an impact on patient prognosis.