土耳其院外心脏骤停多中心前瞻性研究：TROHCA

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-07-01 DOI:10.4103/tjem.tjem_73_24

Alp Şener, M. Pekdemir, M. Islam, E. Aksay, S. Karahan, G. Aksel, N. Doğan, Berkant Öztürk, Muhammet Hacımustafaoğlu, Çağrı Türkücü, S. Eroğlu, Yusuf Yürümez, Nuray Aslan, Necip Gökhan Güner, N. User, Hüseyin Aldemir, A. S. Girişgin, S. Koçak, Sami Ataman, Ayhan Özhasenekler, Gül Pamukçu Günaydın, M. Sayhan, Ömer Salt, Satuk Buğra Han Bozatlı, E. Arslan, F. Yılmaz, Ramazan Sivil, Özlem Köksal, V. Durak, Fatma Özdemir, Mahmut Taş, Yenal Karakoç, Ö. Avınca, Y. Arık, A. Melekoğlu, Özgür Çevrim, Özlem Yiğit, Cem Oktay, Süleyman İbze, S. Satar, Müge Gülen, Selen Acehan, Erhan Altunbaş, Melis Efeoğlu Saçak, Emir Ünal, Erdem Çevik, Dilay Satılmış, Hande Asan, Yunus Karaca, Melih Imamoğlu, Vildan Özer, A. Demircan, Ayfer Keleş, Gultekin Kadi, O. Delice, S. Utlu, Senol Arslan, Neslihan Yücel, Ş. Gürbüz, Hüseyin Burak Ayhan, Abdullah Şen, Mahmut Yaman, M. Günalp, S. Genç, A. Baydın, Fatih Çalışkan, Şeyma Arzu Temür, Murat Ersel, S. Yalçınlı, Enver Özçete, B. Erbil, Elif Ozturk Ince, M. A. Karaca, Murat Çetin, Mehme

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引用次数: 0

摘要

目前还没有足够的数据来清楚地说明土耳其全国院外心脏骤停（OHCA）的情况。本研究首次介绍了院外心脏骤停病例的预后结果以及与这些结果相关的因素。这项研究是在土耳其急诊医学协会复苏研究小组的领导下，采用前瞻性、观察性、多中心设计进行的。研究对象包括土耳其 28 个中心收治的 18 岁及以上 OHCA 病例。存活事件、自发性循环恢复（ROSC）、出院存活率和出院时的神经功能预后是研究的主要结果。最终分析纳入了一千零三名患者。61.1%的患者为男性，平均年龄（67.0 ± 15.2）岁。86.5%的患者在入院前由急救医疗服务人员实施了心肺复苏术（CPR），仅有2.9%的患者由非医护人员实施了旁观者心肺复苏术。因此，患者的存活率为 6.9%。出院时的存活率为 4.4%，其中 2.7% 的患者出院时神经功能状况良好。此外，总体 ROSC 和持续 ROSC 率分别为 45.2% 和 33.4%。在多重逻辑回归分析中，男性性别、初始可电击心律、院前心肺复苏持续时间较短以及急诊科无心肺复苏要求被确定为出院后存活率的独立预测因素。与全球数据相比，在我们的研究中，出院存活率和良好神经功能预后率似乎较低。我们的结论是，这一结果与旁观者心肺复苏率低有关。尽管这不是本研究的重点，但复苏后护理和重症监护支持不足也应在这方面加以讨论。显然，这一问题应通过卫生和社会领域的政治行动加以认真解决。

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Prospective, multicenter, Turkish out-of-hospital cardiac arrest study: TROHCA

There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes. The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes. One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge. Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.