Identification of barriers to early treatment associated with survival from out-of-hospital cardiac arrest in Goteborg

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• 作者：K. Axelsson ; J. Borgstr&#xf6 ; m ; A.B. Axelsson ; J. Herlitz
• 关键词：Cognitive vulnerability ; Information processing ; Depression
• 刊名：Resuscitation
• 出版年：2008
• 期刊代码：236_03009572
• 类别：med
• 出版时间：May 2008
• 卷：77
• 期：Supplement 1
• 页码：S42
• 文件大小：51 K

摘要

Retrospective analysis of a study where data were collected prospectively.

Setting

The Municipality of Göteborg/Mölndal in Sweden.

Patients

All patients suffering from out-of-hospital cardiac arrest in the Municipality of Göteborg/Mölndal in whom cardiopulmonary resuscitation (CPR) was attempted between May 2003 and May 2005.

Interventions

Part of the study cohort, i.e. patients with a witnessed, non-traumatic, out-of-hospital cardiac arrest were distributed (cluster) to mechanical (LUCAS) or manual chest compression.

Results

The overall survival to discharge from hospital among the 508 patients was 8.5%. The corresponding value for non-cardiac cases was 5.1%and for cardiac cases if crew witnessed 16.1%, bystander witnessed 12.7%and non-witnessed 1.4%.

Fifty-nine percent of the patients fulfilled the inclusion criteria for the trial and had no exclusion criteria and 9.7%of these survived to discharge. Ten percent of patients fulfilled the inclusion criteria but were excluded and 20.4%survived to discharge. Thirty-one percent of patients did not fulfil the inclusion criteria and 2.5%survived.

Among patients included in the LUCAS group, many of the survivors, 10/13 (77%), experienced a rapid return of spontaneous circulation (ROSC) before the application of the device.

Conclusion

Among patients with OHCA in whom CPR was started 8.5%survived to hospital discharge and 59%were theoretically available for an early intervention trial. These patients have a different outcome compared with patients not available. However, among those available, the majority of survivors had a rapid ROSC before the application of the intervention (LUCAS). This raises concerns about the potential for early intervention trials to improve outcome after OHCA.