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A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand

OBJECTIVE: This study aimed to explore significant pre-hospital factors affecting the survivability of Out-of-Hospital Cardiac Arrest (OHCA) patients in countries with developing EMS systems. METHOD: A retrospective cohort study was conducted examining data from January 1, 2017 to December 31, 2020...

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Autores principales: Sirikul, Wachiranun, Piankusol, Chanodom, Wittayachamnankul, Borwon, Riyapan, Sattha, Supasaovapak, Jirapong, Wongtanasarasin, Wachira, McNally, Bryan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749449/
https://www.ncbi.nlm.nih.gov/pubmed/35036967
http://dx.doi.org/10.1016/j.resplu.2021.100196
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author Sirikul, Wachiranun
Piankusol, Chanodom
Wittayachamnankul, Borwon
Riyapan, Sattha
Supasaovapak, Jirapong
Wongtanasarasin, Wachira
McNally, Bryan
author_facet Sirikul, Wachiranun
Piankusol, Chanodom
Wittayachamnankul, Borwon
Riyapan, Sattha
Supasaovapak, Jirapong
Wongtanasarasin, Wachira
McNally, Bryan
author_sort Sirikul, Wachiranun
collection PubMed
description OBJECTIVE: This study aimed to explore significant pre-hospital factors affecting the survivability of Out-of-Hospital Cardiac Arrest (OHCA) patients in countries with developing EMS systems. METHOD: A retrospective cohort study was conducted examining data from January 1, 2017 to December 31, 2020 from Utstein Registry databases in Thailand, collected through Pan-Asian Resuscitation Outcomes Study (PAROS). Data were collected from three centres, including regional, suburban-capital, and urban-capital hospitals. The primary endpoint of this study was 30-day survival or discharged alive after an OHCA event. The multivariable risk regression was done by modified Poisson regression with robust error variance to explore the association between 30-day survival and pre-hospital factors with potential confounders adjustments. FINDINGS: Of 1,240 OHCA cases transferred by Emergency Medical Services (EMS), 42 patients (3.4%) were discharged alive after 30 days, including 22 (8.6%), 8 (3.0%), and 12 (1.7%) from regional, suburban-capital, and urban-capital centres, respectively. The initial arrest rhythm was 89.7% unshockable, with no significant variations across the three centres. Overall, bystander Cardiopulmonary Resuscitation (CPR) was 40.4%. However, bystander CPR with Automated External Defibrillator (AED) application was 0.8%. Bystander CPR significantly increased 30-day survival probability (aRR 1.88, 95% CI 1.01 to 3.51; p 0.049). Additionally, reducing the EMS response time by one minute significantly increased OHCA survivability (aRR 1.12, 95% CI 1.04 to 1.20; p 0.001). CONCLUSIONS: Response time and bystander CPR are the factors that improve the 30-day survival outcomes of OHCA patients. In contrast, scene time, transport time, and pre-hospital advanced airway management didn’t improve 30-day OHCA survival.
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spelling pubmed-87494492022-01-13 A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand Sirikul, Wachiranun Piankusol, Chanodom Wittayachamnankul, Borwon Riyapan, Sattha Supasaovapak, Jirapong Wongtanasarasin, Wachira McNally, Bryan Resusc Plus Clinical Paper OBJECTIVE: This study aimed to explore significant pre-hospital factors affecting the survivability of Out-of-Hospital Cardiac Arrest (OHCA) patients in countries with developing EMS systems. METHOD: A retrospective cohort study was conducted examining data from January 1, 2017 to December 31, 2020 from Utstein Registry databases in Thailand, collected through Pan-Asian Resuscitation Outcomes Study (PAROS). Data were collected from three centres, including regional, suburban-capital, and urban-capital hospitals. The primary endpoint of this study was 30-day survival or discharged alive after an OHCA event. The multivariable risk regression was done by modified Poisson regression with robust error variance to explore the association between 30-day survival and pre-hospital factors with potential confounders adjustments. FINDINGS: Of 1,240 OHCA cases transferred by Emergency Medical Services (EMS), 42 patients (3.4%) were discharged alive after 30 days, including 22 (8.6%), 8 (3.0%), and 12 (1.7%) from regional, suburban-capital, and urban-capital centres, respectively. The initial arrest rhythm was 89.7% unshockable, with no significant variations across the three centres. Overall, bystander Cardiopulmonary Resuscitation (CPR) was 40.4%. However, bystander CPR with Automated External Defibrillator (AED) application was 0.8%. Bystander CPR significantly increased 30-day survival probability (aRR 1.88, 95% CI 1.01 to 3.51; p 0.049). Additionally, reducing the EMS response time by one minute significantly increased OHCA survivability (aRR 1.12, 95% CI 1.04 to 1.20; p 0.001). CONCLUSIONS: Response time and bystander CPR are the factors that improve the 30-day survival outcomes of OHCA patients. In contrast, scene time, transport time, and pre-hospital advanced airway management didn’t improve 30-day OHCA survival. Elsevier 2022-01-08 /pmc/articles/PMC8749449/ /pubmed/35036967 http://dx.doi.org/10.1016/j.resplu.2021.100196 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Paper
Sirikul, Wachiranun
Piankusol, Chanodom
Wittayachamnankul, Borwon
Riyapan, Sattha
Supasaovapak, Jirapong
Wongtanasarasin, Wachira
McNally, Bryan
A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand
title A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand
title_full A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand
title_fullStr A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand
title_full_unstemmed A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand
title_short A retrospective multi-centre cohort study: Pre-hospital survival factors of out-of-hospital cardiac arrest (OHCA) patients in Thailand
title_sort retrospective multi-centre cohort study: pre-hospital survival factors of out-of-hospital cardiac arrest (ohca) patients in thailand
topic Clinical Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749449/
https://www.ncbi.nlm.nih.gov/pubmed/35036967
http://dx.doi.org/10.1016/j.resplu.2021.100196
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