2016—2021年上海市中心城区院外心脏骤停患者伤情特征分析

Analysis of injury characteristics of out-of-hospital cardiac arrest patients in the urban area of Shanghai from 2016 to 2021

目的 分析上海市中心城区院外心脏骤停患者伤情特征、院前急救和时间分布情况,以及进行心肺复苏成功(自主循环再现)患者的发生规律和院前急救情况。方法 收集上海市医疗急救中心120调度指挥系统2016至2021年院外心脏骤停患者急救出车数据,并单独筛选自主循环再现患者数据。运用描述性分析、多组样本均数方差分析、R×C卡方检验进行统计分析。结果 纳入有效数据3 744份,其中自主循环再现患者数据1 333份。2016至2021年上海市中心城区院外心脏骤停患者数量逐年增加,以男性为主(59.38%),年龄以75~89岁(1 401例,占37.42%)和60~74岁为主(979例,占26.15%)。平均院前等待时间为(8.61±6.82)min,且逐年缩短(P<0.001)。病因以循环系统(1 805例,占43.03%)和呼吸系统(698例,占16.64%)为主。时间分布方面,10月至次年3月发生数量较多;每日7时至10时和17时至18时是2个呼叫高峰时段。自主循环再现患者共1 333名(25.6%),并且人数逐年增加(P<0.001),救护车到达前心肺复苏和自动体外除颤仪使用率为18.30%和1.43%。结论 揭示了院外心脏骤停发生的季节、时间规律性;院外心脏骤停患平均院前等待时间低于上海市急救平均反应时间,且呈逐年降低的趋势;自主循环再现患者的数量及占比逐年增加,但救护车到达前心肺复苏和自动体外除颤仪使用率仍较低。

Objective To describe the disease characteristics,pre-hospital emergency and time distribution of out-of-hospital cardiac arrest(OHCA)patients and return of spontaneous circulation(ROSC)patients in the urban area of Shanghai.Methods The data of OHCA patients from 2016 to 2021 in the 120-dispatch command system of Shanghai Medical Emergency Center were collected,and data of ROSC patient were screened individually.The data were statistically analyzed using descriptive analysis,multi-group sample mean variance analysis,and R*C chi-square test.Results The study included 3744 valid data,of which 1333 were ROSC patients.From 2016 to 2021,the number of OHCA patients in the urban area of Shanghai increased yearly.The patients were mainly male(59.38%).The main age groups were 75-89 years old(1401,37.42%)and 60-74 years old(979,26.15%).The mean pre hospital waiting time was(8.61±6.82)minutes and decreased yearly(P<0.001).The causes were mainly circulatory system(1805,43.03%)and respiratory system(698,16.64%).In terms of time distribution,there are more occurrences from October to March;7:00 to 10:00 and 17:00 to 18:00 are the two peak call periods.There were 1333 ROSC patients(25.6%),and the number increased yearly(P<0.001).The rates of CPR and AED usage before ambulance arrival were 18.30%and 1.43%.Conclusion This study reveals the seasonal and temporal regularity of OHCA.The average pre hospital waiting time of patients with OHCA is lower than the average response time of first aid in Shanghai,and shows a decreasing trend year by year.The number and proportion of patients with ROSC have increased year by year,but the utilization rate of CPR and AED before ambulance arrival is still low.