A K Sarah, M S Mohd Sidqi, J Md Noor, K D Wong, K M Umul, M Y Low, B Y Chia, F S A Sharifah, A W Mahathar
{"title":"马来西亚三个州紧急医疗服务响应的院外心脏骤停病例的特征和结果。","authors":"A K Sarah, M S Mohd Sidqi, J Md Noor, K D Wong, K M Umul, M Y Low, B Y Chia, F S A Sharifah, A W Mahathar","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>IOut-of-hospital cardiac arrest (OHCA) is globally a critical, time-sensitive emergency with varying outcomes. In Asia, the Pan Asian Resuscitation Outcome Study reported survival rates between 0.5% to 8.5%. We aim to describe the characteristics and outcomes of OHCA cases responded to by Emergency Medical Services (EMS) across several cities in Sarawak, Penang and Klang Valley in Malaysia.</p><p><strong>Materials and methods: </strong>This retrospective observational study analysed EMS data from Sarawak, Penang and Klang Valley from 2010 to 2019. All OHCA cases where EMS performed cardiopulmonary resuscitation (CPR) were included, regardless of age or aetiology. The primary outcome was survival to hospital admission with the secondary outcome a return of spontaneous circulation (ROSC) prior to Emergency Department arrival.</p><p><strong>Results: </strong>A total of 2,435 OHCA cases were analysed. Median patient age was 58 years, 70% of them are male with 63% had underlying medical conditions, with hypertension being the most common. Out of all cases, 71% of arrests occurred at home, 60% witnessed. Median time from arrest to 999 call was 20 minutes, median time for ambulance arrival thereafter is 17 minutes. Bystander CPR rate was 38%, bystander Automated External Defibrillator (AED) use 1.5- 2.6%. Detection of shockable rhythm on first analysis by EMS was 3.9 to 7.7%. Overall survival to admission rate was 4.76%. ROSC rate before Emergency Department arrival was 2.8%. Survival to admission among bystander-witnessed arrests with shockable rhythm was 14.7%.</p><p><strong>Conclusion: </strong>Survival to admission rates for OHCA patients in the studied Malaysian regions (1.3-6.7%) are lower compared to some Asian countries. Areas for improvement include reducing time from arrest to 999 calls, decreasing time to EMS arrival, and increasing bystander CPR and AED use rates. Implementing the Utstein ten-step implementation strategy, focusing on community-based interventions and improving EMS response, could potentially enhance survival rates in Malaysia.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"80 2","pages":"147-152"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characteristics and outcomes of out-of-hospital cardiac arrest cases responded by emergency medical services across three states in Malaysia.\",\"authors\":\"A K Sarah, M S Mohd Sidqi, J Md Noor, K D Wong, K M Umul, M Y Low, B Y Chia, F S A Sharifah, A W Mahathar\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>IOut-of-hospital cardiac arrest (OHCA) is globally a critical, time-sensitive emergency with varying outcomes. In Asia, the Pan Asian Resuscitation Outcome Study reported survival rates between 0.5% to 8.5%. We aim to describe the characteristics and outcomes of OHCA cases responded to by Emergency Medical Services (EMS) across several cities in Sarawak, Penang and Klang Valley in Malaysia.</p><p><strong>Materials and methods: </strong>This retrospective observational study analysed EMS data from Sarawak, Penang and Klang Valley from 2010 to 2019. All OHCA cases where EMS performed cardiopulmonary resuscitation (CPR) were included, regardless of age or aetiology. The primary outcome was survival to hospital admission with the secondary outcome a return of spontaneous circulation (ROSC) prior to Emergency Department arrival.</p><p><strong>Results: </strong>A total of 2,435 OHCA cases were analysed. Median patient age was 58 years, 70% of them are male with 63% had underlying medical conditions, with hypertension being the most common. Out of all cases, 71% of arrests occurred at home, 60% witnessed. Median time from arrest to 999 call was 20 minutes, median time for ambulance arrival thereafter is 17 minutes. Bystander CPR rate was 38%, bystander Automated External Defibrillator (AED) use 1.5- 2.6%. Detection of shockable rhythm on first analysis by EMS was 3.9 to 7.7%. Overall survival to admission rate was 4.76%. ROSC rate before Emergency Department arrival was 2.8%. Survival to admission among bystander-witnessed arrests with shockable rhythm was 14.7%.</p><p><strong>Conclusion: </strong>Survival to admission rates for OHCA patients in the studied Malaysian regions (1.3-6.7%) are lower compared to some Asian countries. Areas for improvement include reducing time from arrest to 999 calls, decreasing time to EMS arrival, and increasing bystander CPR and AED use rates. Implementing the Utstein ten-step implementation strategy, focusing on community-based interventions and improving EMS response, could potentially enhance survival rates in Malaysia.</p>\",\"PeriodicalId\":39388,\"journal\":{\"name\":\"Medical Journal of Malaysia\",\"volume\":\"80 2\",\"pages\":\"147-152\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical Journal of Malaysia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Malaysia","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Characteristics and outcomes of out-of-hospital cardiac arrest cases responded by emergency medical services across three states in Malaysia.
Introduction: IOut-of-hospital cardiac arrest (OHCA) is globally a critical, time-sensitive emergency with varying outcomes. In Asia, the Pan Asian Resuscitation Outcome Study reported survival rates between 0.5% to 8.5%. We aim to describe the characteristics and outcomes of OHCA cases responded to by Emergency Medical Services (EMS) across several cities in Sarawak, Penang and Klang Valley in Malaysia.
Materials and methods: This retrospective observational study analysed EMS data from Sarawak, Penang and Klang Valley from 2010 to 2019. All OHCA cases where EMS performed cardiopulmonary resuscitation (CPR) were included, regardless of age or aetiology. The primary outcome was survival to hospital admission with the secondary outcome a return of spontaneous circulation (ROSC) prior to Emergency Department arrival.
Results: A total of 2,435 OHCA cases were analysed. Median patient age was 58 years, 70% of them are male with 63% had underlying medical conditions, with hypertension being the most common. Out of all cases, 71% of arrests occurred at home, 60% witnessed. Median time from arrest to 999 call was 20 minutes, median time for ambulance arrival thereafter is 17 minutes. Bystander CPR rate was 38%, bystander Automated External Defibrillator (AED) use 1.5- 2.6%. Detection of shockable rhythm on first analysis by EMS was 3.9 to 7.7%. Overall survival to admission rate was 4.76%. ROSC rate before Emergency Department arrival was 2.8%. Survival to admission among bystander-witnessed arrests with shockable rhythm was 14.7%.
Conclusion: Survival to admission rates for OHCA patients in the studied Malaysian regions (1.3-6.7%) are lower compared to some Asian countries. Areas for improvement include reducing time from arrest to 999 calls, decreasing time to EMS arrival, and increasing bystander CPR and AED use rates. Implementing the Utstein ten-step implementation strategy, focusing on community-based interventions and improving EMS response, could potentially enhance survival rates in Malaysia.
期刊介绍：
Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.
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