Out-of-hospital cardiac arrests in Victoria, 2003-2022: retrospective analysis of Victorian Ambulance Cardiac Arrest Registry data.

IF 6.7 2区医学 Q1 MEDICINE, GENERAL & INTERNAL Medical Journal of Australia Pub Date : 2024-11-18 DOI:10.5694/mja2.52532

Emily Nehme, David Anderson, Ross Salathiel, Anthony Carlyon, Dion Stub, Peter A Cameron, Andrew Wilson, Sile Smith, John J McNeil, Ziad Nehme

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Abstract

Objectives: To examine changes in out-of-hospital cardiac arrest (OHCA) characteristics and outcomes during 2003-2022, and 12-month outcomes for people who experienced OHCA during 1 January 2010 - 30 June 2022.

Study design: Retrospective observational study; analysis of Victorian Ambulance Cardiac Arrest Registry (VACAR) data.

Setting, participants: OHCA events in Victoria not witnessed by emergency medical services personnel, 1 January 2003 - 31 December 2022.

Main outcome measures: Crude and age-standardised annual OHCA incidence rates; survival to hospital discharge.

Results: Of 102 592 OHCA events included in our analysis, 67 756 were in men (66.3%). The age-standardised incidence did not change significantly across the study period (2003: 89.1 cases, 2022: 91.2 cases per 100 000 population; for trend: P = 0.50). The proportion of OHCA cases with attempted resuscitation by emergency medical services in which bystanders attempted cardio-pulmonary resuscitation increased from 40.3% in 2003/2004 to 72.2% in 2021/2022, and that of public access defibrillation from 0.9% to 16.1%. In the Utstein comparator group (witnessed OHCA events in which the initial cardiac rhythm was ventricular fibrillation or ventricular tachycardia, with attempted resuscitation by emergency medical services), the odds of survival to hospital discharge increased during 2003-2022 (adjusted odds ratio (aOR), 3.08; 95% confidence interval [CI], 2.22-4.27); however, the odds of survival was greater than in 2012 only in 2018 (aOR, 1.37; 95% CI, 1.04-1.80) and 2019 (aOR, 1.68; 95% CI, 1.28-2.21). The COVID-19 pandemic was associated with reduced odds of survival (aOR, 0.63; 95% CI, 0.54-0.74). Of 3161 people who survived OHCA and participated in 12-month follow-up, 1218 (38.5%) reported full health according to the EQ-5D.

Conclusion: Utstein survival to hospital discharge increased threefold during 2003-2022, and the proportions of cases in which bystanders provided cardio-pulmonary resuscitation or public access defibrillation increased. The COVID-19 pandemic was associated with a substantial reduction in survival, and new strategies are needed to improve outcomes.

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2003-2022 年维多利亚州院外心脏骤停事件：对维多利亚州救护车心脏骤停登记数据的回顾性分析。

研究目的研究设计：回顾性观察研究；分析维多利亚州救护车心脏骤停登记处（VACAR）数据：回顾性观察研究；分析维多利亚州救护车心脏骤停登记处（VACAR）数据：主要结果测量指标：主要结果测量指标：粗略和年龄标准化的 OHCA 年度发病率；出院后的存活率：在我们分析的 102 592 例 OHCA 事件中，67 756 例为男性（66.3%）。在整个研究期间，年龄标准化发病率变化不大（2003 年：每 10 万人 89.1 例，2022 年：每 10 万人 91.2 例；趋势：P = 0.50）：P = 0.50).旁观者尝试心肺复苏的 OHCA 病例比例从 2003/2004 年的 40.3% 增加到 2021/2022 年的 72.2%，公共场所除颤的比例从 0.9% 增加到 16.1%。在乌特施泰因参照组（初始心律为心室颤动或室性心动过速，并尝试过急救服务复苏的目击型 OHCA 事件）中，2003-2022 年期间出院后存活的几率有所上升（调整后的几率比（aOR），3.08；95% 置信区间[CI]，2.22-4.27）；然而，只有在 2018 年（aOR，1.37；95% CI，1.04-1.80）和 2019 年（aOR，1.68；95% CI，1.28-2.21）的存活几率大于 2012 年。COVID-19 大流行与存活几率降低有关（aOR，0.63；95% CI，0.54-0.74）。在3161名OHCA幸存者中，有1218人（38.5%）接受了为期12个月的随访，根据EQ-5D报告，他们完全健康：结论：2003-2022 年间，乌特斯坦患者出院后的存活率增加了三倍，旁观者提供心肺复苏或公共除颤的病例比例也有所增加。COVID-19大流行导致存活率大幅下降，因此需要新的策略来改善结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Journal of Australia 医学-医学：内科

CiteScore

9.40

自引率

5.30%

发文量

410

审稿时长

3-8 weeks

期刊介绍： The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.