PDF(Pubmed)
Abstract：
Sudden cardiac arrest, particularly out-of-hospital cardiac arrest (OHCA), is a global public health concern. However, limited research exists on the epidemiology of OHCAs occurring in public places, trends and impact of bystander intervention, and influence of extraordinary circumstances. This study investigated the epidemiological factors, bystander characteristics, and outcomes of OHCAs that occurred in public places in South Korea from 2016 to 2021 and analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic. A retrospective analysis was conducted using an Out-of-Hospital Cardiac Arrest Surveillance database, including 33,206 cases of OHCA that occurred in public places. Cases with do-not-resuscitate orders or insufficient data were excluded. A steady increase in bystander-performed cardiopulmonary resuscitation over the years and a constant decrease in bystander automated external defibrillator (AED) use were observed. Survival-to-discharge rates for OHCAs remained relatively steady until a marginal decrease was observed during the pandemic (pandemic, 13.1%; pre-pandemic, 14.4%). Factors affecting survival included the presence of a shockable rhythm, witnessed arrest, cardiac arrest due to disease, use of bystander AED, and period relative to the COVID-19 pandemic. These findings emphasize the critical role of bystanders in outcomes of OHCAs and inform public health strategies on better management of OHCAs in public places.
摘要：
心脏骤停,尤其是院外心脏骤停（OHCA），是全球公共卫生问题。然而,关于公共场所OHCA流行病学的研究有限，旁观者干预的趋势和影响，和特殊情况的影响。本研究调查了流行病学因素，旁观者的特点，以及2016年至2021年在韩国公共场所发生的OHCA的结果，并分析了2019年冠状病毒病（COVID-19）大流行的影响。使用院外心脏骤停监测数据库进行回顾性分析，包括发生在公共场所的33,206例OHCA。排除了不复苏命令或数据不足的病例。多年来，观察到旁观者进行的心肺复苏稳步增加，旁观者自动体外除颤器（AED）的使用不断减少。OHCAs的生存至出院率保持相对稳定，直到大流行期间观察到轻微下降(大流行，13.1%；大流行前，14.4%）。影响生存的因素包括可电击节律的存在，目击逮捕,由于疾病导致的心脏骤停,使用旁观者AED，和相对于COVID-19大流行的时期。这些发现强调了旁观者在OHCA结果中的关键作用，并为改善公共场所OHCA管理的公共卫生策略提供了信息。
