International multi-center real world implementation trial to increase out-of-hospital cardiac arrest survival with a dispatcher-assisted cardio-pulmonary resuscitation package (Pan-Asian resuscitation outcomes study phase 2),Resuscitation

当前位置： X-MOL 学术 › Resuscitation › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

International multi-center real world implementation trial to increase out-of-hospital cardiac arrest survival with a dispatcher-assisted cardio-pulmonary resuscitation package (Pan-Asian resuscitation outcomes study phase 2)
Resuscitation ( IF 6.5 ) Pub Date : 2021-12-30 , DOI: 10.1016/j.resuscitation.2021.12.032
Marcus Eng Hock Ong , Sang Do Shin , Patrick Chow-In Ko , Xinyi Lin , Matthew Huei-Ming Ma , Hyun Wook Ryoo , Kwanhathai Darin Wong , Jirapong Supasaowapak , Chih-Hao Lin , Chan-Wei Kuo , Ramana Rao , Wenwei Cai , Faith Joan Gaerlan , Munawar Khursheed , Do Ngoc Son , Karim Sarah , Mazen El Sayed , Saad Al Qahtani , Hideharu Tanaka

Background

Dispatcher-assisted CPR (DA-CPR) has the potential to deliver early bystander CPR (BCPR) and improve out-of-hospital cardiac arrest (OHCA) survival. This study in the Asia-Pacific evaluated the impact of a DA-CPR program on BCPR rates and survival.

Methods

This was a three-arm, prospective, multi-national, population-based, community-level, implementation trial. Cases between January 2009 and June 2018 from the Pan-Asian Resuscitation Outcomes Study were included. Sites either implemented a comprehensive (with quality improvement tool) or a basic DA-CPR package, or served as controls. Primary outcome was survival-to-discharge/30th day post-arrest. Secondary outcomes were BCPR and favorable neurological outcome. A before-after comparison was made within each country; this before-after change was then compared across the three groups using logistic regression.

Results

170,687 cases were analyzed. Before-after comparison showed that survival to discharge was higher in the ‘implementation’ period in all three groups: comprehensive odds ratio (OR) 1.09, 95% confidence interval (CI; [1.0–1.19]); basic OR 1.14, 95% CI (1.08–1.2); and control OR 1.25, 95% CI (1.02–1.53). Comparing between groups, the comprehensive group had significantly higher change in BCPR (comprehensive vs control ratio of OR 1.86, 95% CI [1.66–2.09]; basic vs control ratio of OR 0.94, 95% CI [0.85–1.05]; and comprehensive vs basic ratio of OR 1.97, 95% CI [1.87–2.08]) and survival with favorable neurological outcome (comprehensive vs basic ratio of OR 1.2, 95% CI [1.04–1.39]).

Conclusion

We evaluated the impact of a DA-CPR program across heterogeneous EMS systems and demonstrated that a comprehensive DA-CPR program had the most impact on BCPR and favorable neurological outcome.

中文翻译：

通过调度员辅助心肺复苏包增加院外心脏骤停存活率的国际多中心现实世界实施试验（泛亚复苏结果研究第 2 阶段）

背景

调度员辅助心肺复苏术 (DA-CPR) 有可能提供早期旁观者心肺复苏术 (BCPR) 并提高院外心脏骤停 (OHCA) 的存活率。这项在亚太地区开展的研究评估了 DA-CPR 计划对 BCPR 率和生存率的影响。

方法

这是一项三臂、前瞻性、多国、基于人群、社区层面的实施试验。纳入了泛亚复苏结果研究中 2009 年 1 月至 2018 年 6 月期间的病例。站点要么实施了全面的（带有质量改进工具）或基本的 DA-CPR 包，要么作为控制。主要结果是生存出院/逮捕后第 30 天。次要结果是 BCPR 和良好的神经系统结果。在每个国家/地区进行了前后比较；然后使用逻辑回归在三组之间比较这种前后变化。

结果

分析了 170,687 例。前后比较显示，所有三组在“实施”期间出院的存活率都较高：综合优势比 (OR) 1.09，95% 置信区间 (CI; [1.0–1.19])；基本或 1.14, 95% CI (1.08–1.2); 和控制 OR 1.25, 95% CI (1.02–1.53)。组间比较，综合组的 BCPR 变化显着更高（综合 vs 控制比 OR 1.86, 95% CI [1.66-2.09]；基础 vs 控制比 OR 0.94, 95% CI [0.85-1.05]；综合与 OR 1.97 的基本比率，95% CI [1.87–2.08]）和具有良好神经系统结果的存活率（OR 1.2，95% CI [1.04–1.39] 的综合与基本比率）。