지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2019.1
- 수록면
- 1 - 13 (13page)
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초록· 키워드
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Background: Electrocardiogram (ECG) rhythms, particularly shockable rhythms, are crucial for planning cardiac arrest treatment. There are varying opinions regarding treatment guidelines depending on ECG rhythm types and documentation times within pre-hospital settings or after hospital arrivals. We aimed to determine survival and neurologic outcomes based on ECG rhythm types and documentation times. Methods: This prospective observational study of 64 emergency medical centers was performed using non-traumatic out-of-hospital cardiac arrest registry data between October 2015 and June 2017. From among 4,608 adult participants, 4,219 patients with pre-hospital and hospital ECG rhythm data were enrolled. Patients were divided into 3 groups: those with initial-shockable, converted-shockable, and never-shockable rhythms. Patient characteristics and survival outcomes were compared between groups. Further, termination of resuscitation (TOR) validation was performed for 6 combinations of TOR criteria confirmed in previous studies, including 2 rules developed in the present study. Results: Total survival to discharge after cardiac arrest was 11.7%, and discharge with good neurologic outcomes was 7.9%. Survival to discharge rates and favorable neurologic outcome rates for the initial-shockable group were the highest at 35.3% and 30.2%, respectively. There were no differences in survival to discharge rates and favorable neurologic outcome rates between the converted-shockable (4.2% and 2.0%, respectively) and never-shockable groups (5.7% and 1.9%, respectively). Irrespective of rhythm changes before and after hospital arrival, TOR criteria inclusive of unwitnessed events, no pre-hospital return of spontaneous circulation, and asystole in the emergency department best predicted poor neurologic outcomes (area under the receiver operating characteristic curve of 0.911) with no patients classified as Cerebral Performance Category 1 or 2 (specificity = 1.000). Conclusion: Survival outcomes and TOR predictions varied depending on ECG rhythm types and documentation times within pre-hospital filed or emergency department and should, in the future, be considered in treatment algorithms and prognostications of patients with out- of-hospital cardiac arrest.
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참고문헌 (22)
참고문헌 신청
양혁준 / 2015 / Epidemiology and Outcomes in Out-of-hospital Cardiac Arrest: A Report from the NEDIS-Based Cardiac Arrest Registry in Korea / Journal of Korean Medical Science 30(1):95~103
Wissenberg M / 2013 / Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest / JAMA 310(13):1377~1384
Hasegawa M / 2015 / The number of prehospital defibrillation shocks and 1-month survival in patients with out-of-hospital cardiac arrest / Scand J Trauma Resusc Emerg Med 23(1):34
Mader TJ / 2012 / Out-of-hospital cardiac arrest outcomes stratified by rhythm analysis / Resuscitation 83(11):1358~1362
Hallstrom A / 2007 / The relationship between shocks and survival in out-of-hospital cardiac arrest patients initially found in PEA or asystole / Resuscitation 74(3):418~426
Wissenberg M / 2013 / Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest / JAMA 310(13):1377~1384
Hasegawa M / 2015 / The number of prehospital defibrillation shocks and 1-month survival in patients with out-of-hospital cardiac arrest / Scand J Trauma Resusc Emerg Med 23(1):34
Mader TJ / 2012 / Out-of-hospital cardiac arrest outcomes stratified by rhythm analysis / Resuscitation 83(11):1358~1362
Hallstrom A / 2007 / The relationship between shocks and survival in out-of-hospital cardiac arrest patients initially found in PEA or asystole / Resuscitation 74(3):418~426
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