High survival rate of 43% in out-of-hospital cardiac arrest patients in an optimised chain of survival

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• 作者：L. W. Boyce (1) (8)
  T. P. M. Vliet Vlieland (1) (2)
  J. Bosch (3)
  R. Wolterbeek (4)
  G. Volker (1)
  H. J. van Exel (1) (5)
  C. Heringhaus (6)
  M. J. Schalij (5)
  P. H. Goossens (1) (7)
  
• 关键词：Out of hospital cardiac arrest ; Survival ; Cardiopulmonary resuscitation
• 刊名：Netherlands Heart Journal
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：23
• 期：1
• 页码：20-25
• 全文大小：174 KB
• 参考文献：1. Berdowski J, Berg R, Tijssen JGP, et al. Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation. 2010;81(11):1479-7. doi:10.1016/j.resuscitation.2010.08.006 . j.resuscitation.2010.08.006" target="_blank" title="It opens in new window">CrossRef
  2. Hulleman M, Berdowski J, de Groot, et al. Implantable cardioverter-defibrillators have reduced the incidence of resuscitation for out-of-hospital cardiac arrest caused by lethal arrhythmias. Circulation. 2012;126(7):815-1. doi:10.1161/CIRCULATIONAHA.111.089425 . CrossRef
  3. Waalewijn R, de Vos R, Koster RW. Out-of-hospital cardiac arrests in Amsterdam and its surrounding areas: results from the Amsterdam resuscitation study (ARREST) in “Utstein-style. Resuscitation. 1998;38(3):157-7. CrossRef
  4. Sasson C, Rogers MAM, Dahl J, et al. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3(1):63-1. doi:10.1161/CIRCOUTCOMES.109.889576 . CrossRef
  5. Stub D, Smith K, Bray JE, et al. Hospital characteristics are associated with patient outcomes following out-of-hospital cardiac arrest. Heart. 2011;97(18):1489-4. doi:10.1136/hrt.2011.226431 . CrossRef
  6. Johnson NJ, Salhi RA, Abella BS, et al. Emergency department factors associated with survival after sudden cardiac arrest. Resuscitation. 2012;84(3):292-. doi:10.1016/j.resuscitation.2012.10.013 . j.resuscitation.2012.10.013" target="_blank" title="It opens in new window">CrossRef
  7. Six AJ, Backus BE, Kingma A, et al. Consumption of diagnostic procedures and other cardiology care in chest pain patients after presentation at the emergency department. Neth Heart J. 2012;20(12):499-04. doi:10.1007/s12471-012-0322-6 . CrossRef
  8. Arawwawala D, Brett SJ. Clinical review: beyond immediate survival from resuscitation-long-term outcome considerations after cardiac arrest. Crit Care. 2007;11(6):235. doi:10.1186/cc6139 . CrossRef
  9. Weisfeldt ML, Sitlani CM, Ornato, et al. Survival after application of automatic external defibrillators before arrival of the emergency medical system: evaluation in the resuscitation outcomes consortium population of 21 million. J Am Coll Cardiol. 2010;55(16):1713-0. j.jacc.2009.11.077" target="_blank" title="It opens in new window">CrossRef
  10. Berdowski J, Blom MT, Bardai A, et al. Impact of onsite or dispatched automated external defibrillator use on survival after out-of-hospital cardiac arrest. Circulation. 2011;124(20):2225-2. doi:10.1161/CIRCULATIONAHA.110.015545 . CrossRef
  11. Van Engen-Verheul M, de Vries H, Kemps H, et al. Cardiac rehabilitation uptake and its determinants in the Netherlands. Eur J Prev Cardiol. 2013;20(2):349-6. doi:10.1177/2047487312439497 . CrossRef
  
• 作者单位：L. W. Boyce (1) (8)
  T. P. M. Vliet Vlieland (1) (2)
  J. Bosch (3)
  R. Wolterbeek (4)
  G. Volker (1)
  H. J. van Exel (1) (5)
  C. Heringhaus (6)
  M. J. Schalij (5)
  P. H. Goossens (1) (7)
  
  1. Rijnlands Rehabilitation Centre, Wassenaarseweg 501, 2333AL, Leiden, the Netherlands
  8. Rijnlands Rehabilitation Centre, PO Box 176, 2300 AD, Leiden, the Netherlands
  2. Department of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
  3. Emergency Medical Service Hollands Midden, Vondellaan 43, 2332 AA, Leiden, the Netherlands
  4. Department of Medical Statistics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC, Leiden, the Netherlands
  5. Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
  6. Department of Accident and Emergency, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
  7. Department of Rehabilitation, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
  
• ISSN：1876-6250

文摘

Aims Survival to hospital discharge after out-of-hospital cardiac arrest (OHCA) varies widely. This study describes short-term survival after OHCA in a region with an extensive care path and a follow-up of 1?year. Methods Consecutive patients ?6?years admitted to the emergency department between April 2011 and December 2012 were included. In July 2014 a follow-up took place. Socio-demographic data, characteristics of the OHCA and interventions were described and associations with survival were determined. Results Two hundred forty-two patients were included (73?% male, median age 65?years). In 76?% the cardiac arrest was of cardiac origin and 52?% had a shockable rhythm. In 74?% the cardiac arrest was witnessed, 76?% received bystander cardiopulmonary resuscitation and in 39?% an automatic external defibrillator (AED) was used. Of the 168 hospitalised patients, 144 underwent therapeutic procedures. A total of 105 patients survived until hospital discharge. Younger age, cardiac arrest in public area, witnessed cardiac arrest, cardiac origin with a shockable rhythm, the use of an AED, shorter time until return of spontaneous circulation, Glasgow Coma Scale (GCS) ?3 during transport and longer length of hospital stay were associated with survival. Of the 105 survivors 72 survived for at least 1?year after cardiac arrest and 6 patients died. Conclusion A survival rate of 43?% after OHCA is achievable. Witnessed cardiac arrest, cardiac cause of arrest, initial cardiac rhythm and GCS ?3 were associated with higher survival.