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The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis
Critical Care ( IF 8.8 ) Pub Date : 2020-02-22 , DOI: 10.1186/s13054-020-2773-2
Shijiao Yan 1, 2 , Yong Gan 3 , Nan Jiang 3 , Rixing Wang 4 , Yunqiang Chen 2, 5 , Zhiqian Luo 2, 5 , Qiao Zong 6 , Song Chen 7 , Chuanzhu Lv 2, 4, 5
Affiliation  

Background To quantitatively summarize the available epidemiological evidence on the survival rate of out-of-hospital cardiac arrest (OHCA) patients who received cardiopulmonary resuscitation (CPR). Methods We systematically searched the PubMed, Embase, and Web of Science databases, and the references of retrieved articles were manually reviewed to identify studies reporting the outcome of OHCA patients who received CPR. The overall incidence and outcome of OHCA were assessed using a random-effects meta-analysis. Results A total of 141 eligible studies were included in this meta-analysis. The pooled incidence of return of spontaneous circulation (ROSC) was 29.7% (95% CI 27.6–31.7%), the rate of survival to hospital admission was 22.0% (95% CI 20.7–23.4%), the rate of survival to hospital discharge was 8.8% (95% CI 8.2–9.4%), the pooled 1-month survival rate was 10.7% (95% CI 9.1–13.3%), and the 1-year survival rate was 7.7% (95% CI 5.8–9.5%). Subgroup analysis showed that survival to hospital discharge was more likely among OHCA patients whose cardiac arrest was witnessed by a bystander or emergency medical services (EMS) (10.5%; 95% CI 9.2–11.7%), who received bystander CPR (11.3%, 95% CI 9.3–13.2%), and who were living in Europe and North America (Europe 11.7%; 95% CI 10.5–13.0%; North America: 7.7%; 95% CI 6.9–8.6%). The survival to discharge (8.6% in 1976–1999 vs. 9.9% in 2010–2019), 1-month survival (8.0% in 2000–2009 vs. 13.3% in 2010–2019), and 1-year survival (8.0% in 2000–2009 vs. 13.3% in 2010–2019) rates of OHCA patients who underwent CPR significantly increased throughout the study period. The Egger’s test did not indicate evidence of publication bias for the outcomes of OHCA patients who underwent CPR. Conclusions The global survival rate of OHCA patients who received CPR has increased in the past 40 years. A higher survival rate post-OHCA is more likely among patients who receive bystander CPR and who live in Western countries.

中文翻译:

接受心肺复苏术的成年院外心脏骤停患者的全球生存率:系统评价和荟萃分析

背景 为了定量总结接受心肺复苏术 (CPR) 的院外心脏骤停 (OHCA) 患者存活率的现有流行病学证据。方法 我们系统地检索了 PubMed、Embase 和 Web of Science 数据库,并对检索到的文章的参考文献进行人工审查,以确定报告接受 CPR 的 OHCA 患者结果的研究。使用随机效应荟萃分析评估 OHCA 的总体发生率和结果。结果 本荟萃分析共纳入 141 项符合条件的研究。自主循环恢复(ROSC)的汇总发生率为 29.7%(95% CI 27.6-31.7%),入院生存率为 22.0%(95% CI 20.7-23.4%),住院生存率为放电为 8.8% (95% CI 8.2–9.4%),汇总的 1 个月生存率为 10.7%(95% CI 9.1-13.3%),1 年生存率为 7.7%(95% CI 5.8-9.5%)。亚组分析显示,在旁观者或紧急医疗服务 (EMS) 目击到心脏骤停的 OHCA 患者(10.5%;95% CI 9.2–11.7%),接受旁观者 CPR(11.3%, 95% CI 9.3–13.2%),以及居住在欧洲和北美(欧洲 11.7%;95% CI 10.5–13.0%;北美:7.7%;95% CI 6.9–8.6%)。出院生存率(1976-1999 年为 8.6%,2010-2019 年为 9.9%),1 个月生存率(2000-2009 年为 8.0%,2010-2019 年为 13.3%)和 1 年生存率(8.0%) 2000-2009 年与 2010-2019 年的 13.3%)在整个研究期间接受 CPR 的 OHCA 患者率显着增加。Egger 检验并未表明接受 CPR 的 OHCA 患者结果存在发表偏倚的证据。结论 过去 40 年来,接受 CPR 的 OHCA 患者的全球生存率有所提高。在接受旁观者 CPR 且居住在西方国家的患者中,OHCA 后的存活率更高。
更新日期:2020-02-22
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