湖南省住院患者现场救护参与情况及结局影响因素分析

Participating in on-the-spot first aid,outcome and influencing factors of the participation:an online survey among inpatients in Hunan province

目的了解湖南省住院患者现场救护参与情况及结局的影响因素,为提高院前急救和现场救护水平提供参考依据。方法于2022年1—2月采用分层随机抽样方法在湖南省抽取109家医疗机构共6004例住院患者就其参与现场救护情况和末次参与救护结局进行了问卷调查,并应用多因素非条件logistic回归模型分析现场救护结局的影响因素。结果湖南省最终纳入分析的5964例住院患者中,有1136例(19.05%)住院患者遇到过现场救护事件,其中参与过现场救护的住院患者440例(38.73%);参与现场救护的方式主要为拨打120急救电话(71.86%)和送往医院(24.42%),心肺复苏(12.79%)和电除颤(2.56%)等专业急救方式使用较少;住院患者参与的末次现场救护中,213例(48.41%)被救者治愈,127例(28.86%)被救者好转,75例(17.05%)被救者死亡,25例(5.68%)被救者结局不清;多因素非条件logistic回归分析结果显示,抵达现场进行救护的时间≥10 min是影响湖南省住院患者参与现场救护结局的不利因素,参与现场救护次数≥3次和参与现场救护时救护车抵达时间≤30 min是影响湖南省住院患者参与现场救护结局的有利因素。结论湖南省住院患者参与现场救护比例较低,参与现场救护次数、抵达现场进行救护的时间和参与现场救护时救护车抵达时间是湖南省住院患者参与现场救护结局的主要影响因素。

Objective To examine the participation in on-the-spot first aid among inpatients in Hunan province and the outcome and influencing factors of the participation for providing a reference to improve pre-hospital emergency and field rescue.Methods Using stratified random sampling and a self-designed questionnaire,an online survey was conducted among 6004 inpatients in 109 medical institutions in Hunan province during January-February 2022.The information on the inpatients′participation in on-the-spot first aid,the outcomes and influencing factors of their participations were collected and analyzed.Unconditional multivariate logistic regression model was used to explore influencing factors for outcomes of the on-the-spot first aid actions.Results For the 5964 inpatients finally included in the analysis,1136(19.05%)reported ever encountering on-site rescue events.Among the 1136 inpatients ever encountering on-site rescue events,440(38.73%)had participated in on-site rescue.Of the 440 participants taking on-site rescue,71.86%called emergency services;24.42%sent the first aid recipients to hospital;12.79%performed cardiopulmonary resuscitation;and 2.56%conducted electric defibrillation.For all the first aid recipients in the on-thespot first aids being involved by the inpatient participants,213(48.41%)were cured,127(28.86%)were improved,75(17.05%)died,and 25(5.68%)had an unknown outcome.The results of unconditional multivariate logistic regression analysis showed that emergency personnel not arriving at the first aid site within 10 minutes was a hindering factor for the outcomes of the latest on-the-spot first aid;ever participating in on-the-spot first aid more than 3 times and emergency personnel arriving at the first aid site within 30 minutes were promoting factors for the outcomes of the latest on-the-spot first aid.Conclusion The participation of on-the-spot first aid was low among inpatients in Hunan province.The outcome of the resued persons for the latest on-the-spot first aid being involved by the inpatient participants was mainly influenced by the time of emergency personnel arriving at the first aid site and the frequency of inpatients′ever participating in on-the-spot first aid.