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Association between prehospital prognostic factors on out-of-hospital cardiac arrest in different age groups

机译:在不同年龄群中医院内心脏骤停的前预后因素与临时预后因素的关系

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摘要

Abstract Background The prognosis of out-of-hospital cardiac arrest (OHCA) is very poor. While several prehospital factors are known to be associated with improved survival, the impact of prehospital factors on different age groups is unclear. The objective of the study was to access the impact of prehospital factors and pre-existing comorbidities on OHCA outcomes in different age groups. Methods A retrospective observational analysis was conducted using the emergency medical service (EMS) database from January 2015 to December 2019. We collected information on prehospital factors, underlying diseases, and outcome of OHCAs in different age groups. Kaplan-Meier type survival curves and multivariable logistic regression were used to analyze the association between modifiable pre-hospital factors and outcomes. Results A total of 4188 witnessed adult OHCAs were analyzed. For the age group 1 (age ≦75 years old), after adjustment for confounding factors, EMS response time (odds ratio [OR] = 0.860, 95% confidence interval [CI]: 0.811–0.909, p < 0.001), public location (OR = 1.843, 95% CI: 1.179–1.761, p < 0.001), bystander CPR (OR = 1.329, 95% CI: 1.007–1.750, p = 0.045), attendance by an EMT-Paramedic (OR = 1.666, 95% CI: 1.277–2.168, p < 0.001), and prehospital defibrillation by automated external defibrillator (AED)(OR = 1.666, 95% CI: 1.277–2.168, p  75 years old), age (OR = 0.924, CI:0.880–0.966, p = 0.001), EMS response time (OR = 0.833, 95% CI: 0.742–0.928, p = 0.001), public location (OR = 4.290, 95% CI: 2.450–7.343, p < 0.001), and attendance by an EMT-Paramedic (OR = 2.702, 95% CI: 1.704–4.279, p < 0.001) were independent prognostic factors for survival to hospital discharge in OHCA patients. Conclusions There were variations between younger and older OHCA patients. We found that bystander CPR and prehospital defibrillation by AED were independent prognostic factors for younger OHCA patients but not for the older group.
机译:摘要背景院外心脏骤停(OHCA)的预后非常差。虽然已知几种预孢子因子与改善的存活相关,但在不同年龄组对不同年龄组的影响尚不清楚。该研究的目的是通过在不同年龄组的OHCA结果中获得前孢子因子和预先存在的合并症的影响。方法采用2015年1月至2019年12月,使用紧急医疗服务(EMS)数据库进行回顾性观察分析。我们在不同年龄段中收集了关于OHCAS的潜在因子,潜在疾病和结果的信息。 Kaplan-Meier型生存曲线和多变量逻辑回归用于分析可修改的医院内部因素和结果之间的关联。结果共分析了4188个见证的成年人权办事处。对于年龄组1(年龄≤75岁),在调整混淆因素后,EMS响应时间(差距[或] = 0.860,95%置信区间[CI]:0.811-0.909,P <0.001),公共场所(或= 1.843,95%CI:1.179-1.761,P <0.001),旁观者CPR(或= 1.329,95%CI:1.007-1.750,P = 0.045),由EMT-Paramedic出席(或= 1.666,95 %CI:1.277-2.168,P <0.001)和通过自动外部除颤器(AED)(或= 1.666,95%CI:1.277-2.168,P 75岁),年龄(或= 0.924,CI:0.880 -0.966,p = 0.001),EMS响应时间(或= 0.833,95%CI:0.742-0.928,P = 0.001),公共位置(或= 4.290,95%CI:2.450-7.343,P <0.001),以及EMT-Paramedic的出席(或= 2.702,95%CI:1.704-4.279,P <0.001)是在OHCA患者中存活到医院放电的自主预后因素。结论年轻和较老的OHCA患者之间存在变化。我们发现旁观者的CPR和AED的预孢子除颤是年轻的OHCA患者的独立预后因素,但不是较旧的群体。

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