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J Korean Soc Emerg Med > Volume 34(2); 2023 > Article
Journal of The Korean Society of Emergency Medicine 2023;34(2): 105-114.
일개 도시에서 발생한 병원 밖 성인 심정지 환자들에 대한 분석 및 시계열 변화에 대한 고찰
이일환1, 안성준1 , 김용환1 , 이준호1 , 이동우1 , 박종윤1 , 황성연1 , 이경렬2
1성균관대학교 의과대학 삼성창원병원 응급의학과
2경남대학교 체육교육학과
Out-of-hospital cardiac arrest: incidence, patient characteristics, outcomes, and trends over time between 2012 and 2018 in an urban city
Il Hwan Lee1, Seong Jun Ahn1 , Yong Hwan Kim1 , Jun Ho Lee1 , Dong Woo Lee1 , Jong Yoon Park1 , Seong Youn Hwang1 , Kyoung Yul Lee2
1Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
2Department of Physical Education, Kyungnam University, Changwon, Korea
Correspondence  Yong Hwan Kim ,Tel: 055-233-6119, Fax: 055-233-8394, Email: suka1212@naver.com,
Received: April 18, 2022; Revised: June 10, 2022   Accepted: June 16, 2022.  Published online: April 30, 2023.
ABSTRACT
Objective:
This study aimed to determine the incidence, characteristics, and outcomes of out-of-hospital cardiac arrests (OHCA) and to investigate the trends for the same in Changwon city, South Korea between 2012 and 2018.
Method:
We analyzed a list of adult cardiac arrest cases occurring between 2012 and 2018 from the OHCA surveillance registry and the Changwon Fire Department’s emergency medical services database. The trends in the incidence and resuscitation-related characteristics were assessed using nonparametric tests for trends across ordered groups. The predictors of the primary outcome were investigated using multivariable logistic regression. The primary outcome was a good neurological outcome at hospital discharge.
Results:
A total of 2,951 OHCAs were attended by the emergency medical services and of these, 2,834 were included in this study. Overall, the proportion of patients discharged with a good neurologic outcome was 4.7% (133/2,834). Both OHCA survival and good neurologic outcomes improved significantly over time, from 4.9% and 2.1%, respectively, in 2012 to 10.3% and 7.4% in 2018 (P<0.001). The Utstein comparator (bystander-witnessed arrests presenting with initial shockable rhythm) increased over the study period (P-for-trend<0.001). Age, response time, scene time, in-hospital cardiopulmonary resuscitation (CPR) time, witness presence, cardiac origin, and shockable rhythm were associated with good neurologic outcomes.
Conclusion:
With the gradual increase in the proportion of patients with witnessed cardiac arrests, bystander CPR, and initial shockable rhythm, the rate of survival and a good neurologic outcome at discharge also increased annually.
Key words: Out-of-hospital cardiac arrest; Character; Incidence; Trends
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