|Göteborgs universitets publikationer
Characteristics and outcome among patients suffering from out-of-hospital cardiac arrest with the emphasis on availability for intervention trials
Författare och institution:
Christer Axelsson (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); Åsa B. Axelsson (Institutionen för vårdvetenskap och hälsa); L. Svensson (-); Johan Herlitz (Institutionen för medicin, avdelningen för molekylär och klinisk medicin)
Artikel, refereegranskad vetenskaplig
AIM: To describe all patients treated for out-of-hospital cardiac arrest (OHCA) according to the Utstein criteria and their characteristics and outcome with emphasis on whether they were available for early intervention trials. DESIGN: Retrospective analysis of a study where data were collected prospectively. SETTING: The Municipality of Goteborg/Molndal in Sweden. PATIENTS: All patients suffering from out-of-hospital cardiac arrest in the Municipality of Goteborg/Molndal in whom cardiopulmonary resuscitation (CPR) was attempted between May 2003 and May 2005. INTERVENTIONS: Part of the study cohort, i.e. patients with a witnessed, non-traumatic, out-of-hospital cardiac arrest were distributed (cluster) to mechanical (LUCAS) or manual chest compression. RESULTS: The overall survival to discharge from hospital among the 508 patients was 8.5%. The corresponding value for non-cardiac cases was 5.1% and for cardiac cases if crew witnessed 16.1%, bystander witnessed 12.7% and non-witnessed 1.4%. Fifty-nine percent of the patients fulfilled the inclusion criteria for the trial and had no exclusion criteria and 9.7% of these survived to discharge. Ten percent of patients fulfilled the inclusion criteria but were excluded and 20.4% survived to discharge. Thirty-one percent of patients did not fulfil the inclusion criteria and 2.5% survived. Among patients included in the LUCAS group, many of the survivors, 10/13 (77%), experienced a rapid return of spontaneous circulation (ROSC) before the application of the device. CONCLUSION: Among patients with OHCA in whom CPR was started 8.5% survived to hospital discharge and 59% were theoretically available for an early intervention trial. These patients have a different outcome compared with patients not available. However, among those available, the majority of survivors had a rapid ROSC before the application of the intervention (LUCAS). This raises concerns about the potential for early intervention trials to improve outcome after OHCA.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP