Aim

Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) can increase bystander CPR rates and improve outcomes in out-of-hospital cardiac arrest (OHCA). Despite the use of protocols, dispatchers may falsely recognise some cases to be in cardiac arrest. Hence, this study aimed to find the incidence of DA-CPR initiated for non-OHCA cases, its characteristics and clinical outcomes in the Singapore population.

Methods

This was a multi-centre, observational study of all dispatcher-recognised cardiac arrests cases between January to December 2017 involving three tertiary hospitals in Singapore. Data was obtained from the Pan-Asian Resuscitation Outcomes Study cohort. Audio review of dispatch calls from the national emergency ambulance service were conducted and information about patients’ clinical outcomes were prospectively collected from health records. Univariate analysis was performed to determine factors associated with in-hospital mortality among non-OHCA patients who received DA-CPR.

Results

Of the 821 patients recognised as having OHCA 328 (40.0%) were not in cardiac arrest and 173 (52.7%) of these received DA-CPR. No complications from chest compressions were found from hospital records. The top diagnoses of non-OHCA patients were cerebrovascular accidents (CVA), syncope and infection. Only final diagnoses of CVA (aOR 20.68), infection (aOR 17.34) and myocardial infarction (aOR 32.19) were significantly associated with in-hospital mortality.

Conclusion

In this study, chest compressions initiated on patients not in cardiac arrest by dispatchers did not result in any reported complications and was not associated with in-hospital mortality. This provides reassurance for the continued implementation of DA-CPR.

中文翻译：

---

调度员辅助心肺复苏在非心脏骤停患者中的发生率、特征和并发症

目的

调度员辅助心肺复苏 (DA-CPR) 可以提高旁观者 CPR 率并改善院外心脏骤停 (OHCA) 的结果。尽管使用了协议，调度员可能会错误地将某些病例识别为心脏骤停。因此，本研究旨在了解新加坡人群中针对非 OHCA 病例启动的 DA-CPR 的发生率、其特征和临床结果。

方法

这是一项多中心的观察性研究，对 2017 年 1 月至 2017 年 12 月期间所有调度员认可的心脏骤停病例，涉及新加坡的三家三级医院。数据来自泛亚复苏结果研究队列。对来自国家紧急救护车服务的调度电话进行了音频审查，并从健康记录中前瞻性地收集了有关患者临床结果的信息。进行单变量分析以确定与接受 DA-CPR 的非 OHCA 患者住院死亡率相关的因素。

结果

在被确认患有 OHCA 的 821 名患者中，328 名（40.0%）未发生心脏骤停，其中 173 名（52.7%）接受了 DA-CPR。从医院记录中未发现胸外按压并发症。非 OHCA 患者的最高诊断是脑血管意外 (CVA)、晕厥和感染。只有 CVA (aOR 20.68)、感染 (aOR 17.34) 和心肌梗死 (aOR 32.19) 的最终诊断与住院死亡率显着相关。

结论

在这项研究中，调度员对未发生心脏骤停的患者进行胸外按压并未导致任何报告的并发症，并且与住院死亡率无关。这为继续实施 DA-CPR 提供了保证。