Objective. This study aimed to elucidate whether direct transport of out-of-hospital cardiac arrest (OHCA) patients to higher-level emergency medical centres (EMCs) would result in better survival compared to resuscitation in smaller local emergency departments (EDs) and subsequent transfer. Methods. This study was a retrospective population-based analysis of cases registered in the national database of 2019. This study investigated the immediate results of cardiopulmonary resuscitation for OHCA compared between EMCs and EDs and the results of therapeutic temperature management (TTM) compared between the patients directly transported from the field and those transferred from other hospitals. In-hospital mortality was compared using multivariate logistic regression. Results. From the population dataset, 11,493 OHCA patients were extracted. (8,912 in the EMC group vs. 2,581 in the ED group). Multivariate logistic regression revealed that the odds for ED mortality were lower with treatment in EDs than with treatment in EMCs. (odds ratio 0.712 (95% confidence interval (CI): 0.638–0.796)). From the study dataset, 1,798 patients who received TTM were extracted. (1,164 in the direct visit group vs. 634 in the transferred group). Multivariate regression analysis showed that the odds ratio for overall mortality was 1.411 (95% CI: 0.809–2.446) in the transferred group. (). Conclusion. The immediate outcome of OHCA patients who were transported to EDs was not inferior to that of EMCs. Therefore, it would be acceptable to transport OHCA patients to the nearest emergency facilities rather than to the specialized centres in distant areas.

中文翻译：

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急救医疗设施水平对心脏骤停短期救治结果的影响：院外心脏骤停和院间转运

客观。本研究旨在阐明将院外心脏骤停 (OHCA) 患者直接转运到更高级别的急诊医疗中心 (EMC) 是否会比在较小的地方急诊科 (ED) 进行复苏和随后的转移带来更好的生存率。方法。本研究是对 2019 年国家数据库中登记的病例的回顾性基于人群的分析。本研究调查了 EMC 和 ED 之间比较 OHCA 心肺复苏的即时结果以及直接比较患者之间的治疗温度管理 (TTM) 结果从外地运来的和从其他医院转来的。使用多变量逻辑回归比较住院死亡率。结果. 从人口数据集中，提取了 11,493 名 OHCA 患者。（EMC 组为 8,912，ED 组为 2,581）。多变量逻辑回归显示，ED 治疗的 ED 死亡率几率低于 EMC 治疗。（优势比 0.712（95% 置信区间 (CI)：0.638–0.796））。从研究数据集中，提取了 1,798 名接受 TTM 的患者。（直接访问组 1,164 人，转移组 634 人）。多元回归分析显示，转移组总死亡率的优势比为 1.411（95% CI：0.809-2.446）。(）。 结论。被运送到急诊室的 OHCA 患者的直接结果并不逊于 EMCs。因此，将 OHCA 患者运送到最近的急救设施而不是偏远地区的专业中心是可以接受的。