■描述和探索2012年至2020年期间爱尔兰旁观者除颤的预测因素。目的研究旁观者除颤与卫生系统发展之间的关系。
■询问国家级院外心脏骤停(OHCA)登记数据,专注于进行过除颤的患者。旁观者除颤(与EMS启动的除颤相比)是关注的关键结果。通过拟合预测因子建立和完善Logistic回归模型,执行逐步变量选择,并通过添加改进拟合的成对相互作用。
■数据包括5,751例进行除颤的OHCA。随着时间的推移(OR1.17,95%CI1.13,1.21)与旁观者除颤的校正几率增加相关。非心源性病因与旁观者除颤的校正几率降低相关(OR0.30,95%CI0.21,0.42),年龄增加(OR0.99,95%CI0.987,0.996)和夜间OHCA发生率增加(OR0.67,95%CI0.53,0.83)。最终模型中的六个其他变量(性别,呼叫响应间隔,事故地点(家庭或其他),谁目睹了崩溃(旁观者或未目睹),城市或农村的位置,和COVID期)参与了显著的相互作用。在城市环境和家庭场所,旁观者除颤的可能性通常较小。虽然女性总体上不太可能接受旁观者除颤,在目睹的OHCA中,发生在家庭之外,在城市地区和COVID-19期以外,女性更有可能,接受旁观者除颤。
■在爱尔兰,旁观者的除颤随着时间的推移而逐渐增加。解决性别和年龄差异的干预措施,除了增加夜间旁观者除颤的干预措施,在城市环境和家庭位置是必需的。
UNASSIGNED: To describe and explore predictors of bystander defibrillation in Ireland during the period 2012 to 2020. To examine the relationship between bystander defibrillation and health system developments.
UNASSIGNED: National level Out of Hospital Cardiac Arrest (OHCA) registry data were interrogated, focusing on patients who had defibrillation performed. Bystander defibrillation (as compared to EMS initiated defibrillation) was the key outcome of concern. Logistic regression models were built and refined by fitting predictors, performing stepwise variable selection and by adding pairwise interactions that improved fit.
UNASSIGNED: The data included 5,751 cases of OHCA where defibrillation was performed. Increasing year over time (OR 1.17, 95% CI 1.13, 1.21) was associated with increased adjusted odds of bystander defibrillation. Non-cardiac aetiology was associated with reduced adjusted odds of bystander defibrillation (OR 0.30, 95% CI 0.21, 0.42), as were increasing age in years (OR 0.99, 95% CI 0.987, 0.996) and night-time occurrence of OHCA (OR 0.67, 95% CI 0.53, 0.83). Six further variables in the final model (sex, call response interval, incident location (home or other), who witnessed collapse (bystander or not witnessed), urban or rural location, and the COVID period) were involved in significant interactions. Bystander defibrillation was in general less likely in urban settings and at home locations. Whilst women were less likely to receive bystander defibrillation overall, in witnessed OHCAs, occurring outside the home, in urban areas and outside of the COVID-19 period women were more likely, to receive bystander defibrillation.
UNASSIGNED: Defibrillation by bystanders has increased incrementally over time in Ireland. Interventions to address sex and age-based disparities, alongside interventions to increase bystander defibrillation at night, in urban settings and at home locations are required.