Effects of Post-Hospital Arrival Factors on Out-of-Hospital Cardiac Arrest Outcomes During the COVID-19 Pandemic.

Q4 Medicine
Critical care explorations Pub Date : 2024-09-10 eCollection Date: 2024-09-01 DOI:10.1097/CCE.0000000000001154
Yasuyuki Kawai, Koji Yamamoto, Keita Miyazaki, Hideki Asai, Hidetada Fukushima
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引用次数: 0

Abstract

Importance: The relationship between post-hospital arrival factors and out-of-hospital cardiac arrest (OHCA) outcomes remains unclear.

Objectives: This study assessed the impact of post-hospital arrival factors on OHCA outcomes during the COVID-19 pandemic using a prediction model.

Design, setting, and participants: In this cohort study, data from the All-Japan Utstein Registry, a nationwide population-based database, between 2015 and 2021 were used. A total of 541,781 patients older than 18 years old who experienced OHCA of cardiac origin were included.

Main outcomes and measures: The primary exposure was trends in COVID-19 cases. The study compared the predicted proportion of favorable neurologic outcomes 1 month after resuscitation with the actual outcomes. Neurologic outcomes were categorized based on the Cerebral Performance Category score (1, good cerebral function; 2, moderate cerebral function).

Results: The prediction model, which had an area under the curve of 0.96, closely matched actual outcomes in 2019. However, a significant discrepancy emerged after the pandemic began in 2020, where outcomes continued to deteriorate as the virus spread, exacerbated by both pre- and post-hospital arrival factors.

Conclusions and relevance: Post-hospital arrival factors were as important as pre-hospital factors in adversely affecting the prognosis of patients following OHCA during the COVID-19 pandemic. The results suggest that the overall response of the healthcare system needs to be improved during infectious disease outbreaks to improve outcomes.

在 COVID-19 大流行期间,到达医院后的因素对院外心脏骤停结果的影响。
重要性:入院后因素与院外心脏骤停(OHCA)结果之间的关系仍不清楚:本研究使用预测模型评估了 COVID-19 大流行期间入院后因素对院外心脏骤停结果的影响:在这项队列研究中,使用了 2015 年至 2021 年期间来自全日本 Utstein 登记处(一个基于全国人口的数据库)的数据。共纳入了 541781 名 18 岁以上、经历过心脏源性 OHCA 的患者:主要暴露是 COVID-19 病例的趋势。该研究比较了复苏后 1 个月有利神经系统结果的预测比例与实际结果。神经系统结果根据脑功能分类得分进行分类(1,脑功能良好;2,脑功能中等):预测模型的曲线下面积为 0.96,与 2019 年的实际结果非常吻合。然而,在 2020 年大流行开始后出现了明显的差异,随着病毒的传播,结果继续恶化,而到达医院前后的因素都加剧了这种恶化:在 COVID-19 大流行期间,在对 OHCA 患者的预后产生不利影响方面,入院后因素与入院前因素同样重要。结果表明,在传染病爆发期间,医疗保健系统的整体应对措施需要改进,以改善预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.70
自引率
0.00%
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审稿时长
8 weeks
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