ASSOCIATION OF THE EMERGENCY MEDICAL SERVICES-RELATED TIME INTERVAL WITH SURVIVAL OUTCOMES OF OUT-OF-HOSPITAL CARDIAC ARREST CASES IN FOUR ASIAN METROPOLITAN CITIES USING THE SCOOP-AND-RUN EMERGENCY MEDICAL SERVICES MODEL

作者：Kim Tae Han; Lee Kyungwon^*; Do Shin Sang; Ro Young Sun; Tanaka Hideharu; Yap Susan; Wong Kwanhathai Darin; Ng Yih Yng; Piyasuwankul Thammapad; Leong Benjamin

来源：Journal of Emergency Medicine, 2017, 53(5): 688-+.

DOI：10.1016/j.jemermed.2017.08.076

• emergency medical services
• cardiac arrest
• cardiopulmonary resuscitation

Background: Response time interval (RTI) and scene time interval (STI) are key time variables in the out-of-hospital cardiac arrest (OHCA) cases treated and transported via emergency medical services (EMS). Objective: We evaluated distribution and interactive association of RTI and STI with survival outcomes of OHCA in four Asian metropolitan cities. Methods: An OHCA cohort from Pan-Asian Resuscitation Outcome Study (PAROS) conducted between January 2009 and December 2011 was analyzed. Adult EMS-treated cardiac arrests with presumed cardiac origin were included. A multivariable logistic regression model with an interaction term was used to evaluate the effect of STI according to different RTI categories on survival outcomes. Risk-adjusted predicted rates of survival outcomes were calculated and compared with observed rate. Results: A total of 16,974 OHCA cases were analyzed after serial exclusion. Median RTI was 6.0 min (interquartile range [IQR] 5.0-8.0 min) and median STI was 12.0 min (IQR 8.0-16.1). The prolonged STI in the longest RTI group was associated with a lower rate of survival to discharge or of survival 30 days after arrest (adjusted odds ratio [aOR] 0.59; 95% confidence interval [CI] 0.42- 0.81), as well as a poorer neurologic outcome (aOR 0.63; 95% CI 0.41- 0.97) without an increasing chance of prehospital return of spontaneous circulation (aOR 1.12; 95% CI 0.88- 1.45). Conclusions: Prolonged STI in OHCA with a delayed response time had a negative association with survival outcomes in four Asian metropolitan cities using the scoop-and-run EMS model. Establishing an optimal STI based on the response time could be considered.

• 出版日期2017-11