ADULT OUT-OF-HOSPITAL CARDIAC ARREST BASED ON CHAIN OF SURVIVAL IN TAOYUAN COUNTY, NORTHERN TAIWAN

作者：Kuo Chan Wei; See Lai Chu^*; Tu Hui Tzu; Chen Jih Chang

来源：Journal of Emergency Medicine, 2014, 46(6): 782-790.

DOI：10.1016/j.jemermed.2013.08.026

• out-of-hospital cardiac arrest (OHCA)
• return of spontaneous circulation (ROSC)
• survival
• Taiwan

Background: Most out-of-hospital cardiac arrest (OHCA) studies have been conducted in developed countries ormetropolitan areas, and few in developing countries or rural areas. Objectives: The aims of this study were to determine the weak links in the chain of survival and to estimate the outcomes of OHCA patients in Taoyuan, a nonmetropolitan area in Taiwan. Methods: A retrospective review and analysis of OHCA data was conducted. The three outcomes were whether a return of spontaneous circulation (ROSC) was achieved, whether the patient survived to admission, or whether the patient survived to hospital discharge. Results: From April to December 2008, 1048 OHCA patients were resuscitated, and 712 (67.9%) adult cardiac patients were used in this study. Among these 712 patients, 17.8% achieved ROSC (95% confidence interval [CI] 15.2-20.8%), 16.3% survived to admission (95% CI 13.6-19.0%), and 1.4% survived to discharge (95% CI 0.5-2.3%). Factors significantly associated with the three outcomes were witness status, response time to emergency medical services, and whether the patient had a shockable rhythm. Bystander cardiopulmonary resuscitation (CPR) did not add a notable benefit to the outcomes of OHCA. Conclusions: The survival rate of OHCA patients in nonmetropolitan Taiwan was very low (1.4%). Lower witnessed rate, lower bystander CPR rate, and longer response interval in remote areas are the main causes of inferior survival rate.

• 出版日期2014-6
• 单位长春大学