Belinda Delardes, Mads Christian Tofte Gregers, Emily Nehme, Michael Ray, Dylan Hall, Tony Walker, David Anderson, Daniel Okyere, Ashanti Dantanarayana, Ziad Nehme
{"title":"2018-23年，维多利亚州，智能手机激活的志愿者响应者和院外心脏骤停后的出院存活率：一项观察性队列研究。","authors":"Belinda Delardes, Mads Christian Tofte Gregers, Emily Nehme, Michael Ray, Dylan Hall, Tony Walker, David Anderson, Daniel Okyere, Ashanti Dantanarayana, Ziad Nehme","doi":"10.5694/mja2.52673","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To compare the likelihood of patient survival to discharge and of bystander cardiopulmonary resuscitation (CPR) and defibrillation for cases of out-of-hospital cardiac arrest in which at least one smartphone-activated volunteer responder (SAVR) arrived before emergency medical services (EMS) with cases in which EMS arrived first.</p>\n </section>\n \n <section>\n \n <h3> Study design</h3>\n \n <p>Population-based observational cohort study; analysis of Victorian Ambulance Cardiac Arrest Registry (VACAR) data.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Victoria, 12 February 2018 – 31 August 2023.</p>\n </section>\n \n <section>\n \n <h3> Participants</h3>\n \n <p>All cases of out-of-hospital cardiac arrest not witnessed by EMS personnel, except events in residential aged care facilities, in which EMS personnel did not attempt resuscitation, or for which the EMS dispatch code was ineligible for SAVR activation; events during coronavirus disease 2019 pandemic lockdowns were also excluded (SAVR program pause: rural areas: 23 March 2020 – 16 October 2020; metropolitan areas: 23 March 2020 – 9 November 2020).</p>\n </section>\n \n <section>\n \n <h3> Main outcome measures</h3>\n \n <p>Primary outcome: survival to hospital discharge. Secondary outcomes: bystander CPR, bystander defibrillation, any return of spontaneous circulation.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of 9196 cases of out-of-hospital cardiac arrest included in our analysis, 1158 (12.6%) had been attended by SAVRs: before EMS arrival in 564 cases (48.7%) and after EMS arrival in 594 cases (51.3%). The risk-adjusted odds of patient survival to hospital discharge were higher for events in which SAVRs arrived before EMS than for those not attended by SAVRs (adjusted odds ratio [aOR], 1.37; 95% confidence interval [CI], 1.02–1.85), as were those of bystander CPR (aOR, 7.59; 95% CI, 4.97–11.6) and bystander defibrillation (aOR, 16.0; 95% CI, 9.23–27.7); the likelihood of return of spontaneous circulation was similar for the two event groups. SAVRs arriving after EMS did not influence any of the assessed outcomes.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The arrival of SAVRs before EMS personnel was associated with greater likelihood of patient survival to hospital discharge and of bystander CPR and defibrillation.</p>\n </section>\n </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"222 10","pages":"504-509"},"PeriodicalIF":6.7000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52673","citationCount":"0","resultStr":"{\"title\":\"Smartphone-activated volunteer responders and survival to discharge after out-of-hospital cardiac arrests in Victoria, 2018–23: an observational cohort study\",\"authors\":\"Belinda Delardes, Mads Christian Tofte Gregers, Emily Nehme, Michael Ray, Dylan Hall, Tony Walker, David Anderson, Daniel Okyere, Ashanti Dantanarayana, Ziad Nehme\",\"doi\":\"10.5694/mja2.52673\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>To compare the likelihood of patient survival to discharge and of bystander cardiopulmonary resuscitation (CPR) and defibrillation for cases of out-of-hospital cardiac arrest in which at least one smartphone-activated volunteer responder (SAVR) arrived before emergency medical services (EMS) with cases in which EMS arrived first.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Study design</h3>\\n \\n <p>Population-based observational cohort study; analysis of Victorian Ambulance Cardiac Arrest Registry (VACAR) data.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Setting</h3>\\n \\n <p>Victoria, 12 February 2018 – 31 August 2023.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Participants</h3>\\n \\n <p>All cases of out-of-hospital cardiac arrest not witnessed by EMS personnel, except events in residential aged care facilities, in which EMS personnel did not attempt resuscitation, or for which the EMS dispatch code was ineligible for SAVR activation; events during coronavirus disease 2019 pandemic lockdowns were also excluded (SAVR program pause: rural areas: 23 March 2020 – 16 October 2020; metropolitan areas: 23 March 2020 – 9 November 2020).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Main outcome measures</h3>\\n \\n <p>Primary outcome: survival to hospital discharge. Secondary outcomes: bystander CPR, bystander defibrillation, any return of spontaneous circulation.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of 9196 cases of out-of-hospital cardiac arrest included in our analysis, 1158 (12.6%) had been attended by SAVRs: before EMS arrival in 564 cases (48.7%) and after EMS arrival in 594 cases (51.3%). The risk-adjusted odds of patient survival to hospital discharge were higher for events in which SAVRs arrived before EMS than for those not attended by SAVRs (adjusted odds ratio [aOR], 1.37; 95% confidence interval [CI], 1.02–1.85), as were those of bystander CPR (aOR, 7.59; 95% CI, 4.97–11.6) and bystander defibrillation (aOR, 16.0; 95% CI, 9.23–27.7); the likelihood of return of spontaneous circulation was similar for the two event groups. SAVRs arriving after EMS did not influence any of the assessed outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>The arrival of SAVRs before EMS personnel was associated with greater likelihood of patient survival to hospital discharge and of bystander CPR and defibrillation.</p>\\n </section>\\n </div>\",\"PeriodicalId\":18214,\"journal\":{\"name\":\"Medical Journal of Australia\",\"volume\":\"222 10\",\"pages\":\"504-509\"},\"PeriodicalIF\":6.7000,\"publicationDate\":\"2025-05-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52673\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medical Journal of Australia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.5694/mja2.52673\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Australia","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.5694/mja2.52673","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Smartphone-activated volunteer responders and survival to discharge after out-of-hospital cardiac arrests in Victoria, 2018–23: an observational cohort study
Objectives
To compare the likelihood of patient survival to discharge and of bystander cardiopulmonary resuscitation (CPR) and defibrillation for cases of out-of-hospital cardiac arrest in which at least one smartphone-activated volunteer responder (SAVR) arrived before emergency medical services (EMS) with cases in which EMS arrived first.
All cases of out-of-hospital cardiac arrest not witnessed by EMS personnel, except events in residential aged care facilities, in which EMS personnel did not attempt resuscitation, or for which the EMS dispatch code was ineligible for SAVR activation; events during coronavirus disease 2019 pandemic lockdowns were also excluded (SAVR program pause: rural areas: 23 March 2020 – 16 October 2020; metropolitan areas: 23 March 2020 – 9 November 2020).
Main outcome measures
Primary outcome: survival to hospital discharge. Secondary outcomes: bystander CPR, bystander defibrillation, any return of spontaneous circulation.
Results
Of 9196 cases of out-of-hospital cardiac arrest included in our analysis, 1158 (12.6%) had been attended by SAVRs: before EMS arrival in 564 cases (48.7%) and after EMS arrival in 594 cases (51.3%). The risk-adjusted odds of patient survival to hospital discharge were higher for events in which SAVRs arrived before EMS than for those not attended by SAVRs (adjusted odds ratio [aOR], 1.37; 95% confidence interval [CI], 1.02–1.85), as were those of bystander CPR (aOR, 7.59; 95% CI, 4.97–11.6) and bystander defibrillation (aOR, 16.0; 95% CI, 9.23–27.7); the likelihood of return of spontaneous circulation was similar for the two event groups. SAVRs arriving after EMS did not influence any of the assessed outcomes.
Conclusion
The arrival of SAVRs before EMS personnel was associated with greater likelihood of patient survival to hospital discharge and of bystander CPR and defibrillation.
期刊介绍：
The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.
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