Ten-year monitoring of out-of-hospital cardiac arrest during the implementation of European registry of cardiac arrest in Serbia

[S. S. Ranđelović]

89 listova

Uvod: Vanbolnički srčani zastoj (VBSZ) je jedan od vodećih uzroka smrti u savremenoj populaciji. Do 2014. godine u Republici Srbiji nije bilo doslednih podataka o VBSZ u Srbiji. Cilj ove studije je da analizira učestalost faktora koji utiču na tok i ishode VBSZ u Srbiji i predikciju prehospitalnih ishoda i preživljavanja. Materijal i metode: Podaci su prikupljeni u periodu od 2014. do 2023. godine, prema protokolu studije EuReCa One (ID broj kliničkog ispitivanja NCT02236819). Rezultati: Ukupno 9303 VBSZ događaja registrovano je sa medijanom starosti pacijenta od 71 godine. Ukupno 59.7% pacijenata su bili muškarci. Godišnja incidenca VBSZ bila je 85.60±20.73/100000 stanovnika. U svim slučajevima osvedočenim od strane slučajnog svedoka, kardiopulmonalna reanimacija (KPR) inicirana je od strane svedoka u 15.3%. Unutar grupe sa započetom KPR, povratak spontane cirkulacije (PSC) na mestu zadesa bio je prisutan u 1037/4053 slučaja (25.6%), a PSC na prijemu u najbližu bolnicu u 792/4053 slučaja (19.5%) , dok je 201/4053 pacijenata preživelo do otpusta iz bolnice (5.0%). Prediktivni potencijal prehospitalnih ishoda pokazao je nekoliko faktora. Takođe, od svih pacijenata koji su imali PSC, 89,2% je primljeno u bolnicu živo. Verovatnoća PSC na mestu zadesa pala je ispod 50% nakon što je prošlo 17 minuta nakon hitnog poziva i 10 minuta nakon dolaska ekipe hitne pomoći na mesto zadesa. Zaključci: Stope incidence VBSZ u Srbiji su uporedive sa većinom ranije objavljenih izveštaja. Postoji poboljšanje u uključivanju posmatrača u pružanju KPR mera. Primetne geografske i vremenske varijacije u incidenci VBSZ i dalje su prisutne. KPR iniciran od strane svedoka i faktori vezani za vremenske intervale istaknuti su kao prediktori povoljnih ishoda kod pacijenata sa VBSZ.

Introduction: Out-of-hospital cardiac arrest is one of the leading causes of death in the modern population. Until 2014, in the Republic of Serbia, there were no consistent data on out-ofhospital cardiac arrest in Serbia. The aim of this study is to analyze the frequency of factors influencing the course and outcomes of out-of-hospital cardiac arrest (OHCA) in Serbia and the prediction of pre-hospital outcomes and survival. Material and Methods: Data were collected during the period from 1 October 2014, to 31 September 2023, according to the protocol of the EuReCa_One study (clinical trial ID number NCT02236819). Results: Overall 9303 OHCA events were registered with a median age of 71 (IQR 61–81) years and 59.7% of them being males. The annual OHCA incidence was 85.60 ± 20.73/100,000. Within all bystander-witnessed cases, bystander-initiated cardiopulmonary resuscitation in 15.3%. Within the resuscitation-initiated group, return-of-spontaneous circulation (ROSC) on scene was present in 1037/4053 cases (25.6%) and ROSC on admission to the nearest hospital in 792/4053 cases (19.5%), while 201/4053 patients survived to hospital discharge (5.0%). Predictive potential on pre-hospital outcomes was shown by several factors. Also, of all patients having any ROSC, 89.2% were admitted to the hospital alive. The probability of any ROSC dropped below 50% after 17 min passed after the emergency call and 10 minutes after the EMS scene arrival. Conclusions: Incidence rates of OHCA in Serbia are comparable to most previously published reports. There is an improvement in bystander inclusion in providing CPR measures. Noticeable geographic and time-related variabilities in OHCA incidence are still present among the OHCA reports. Bystander-initiated CPR and time-related factors are highlighted as predictors of favorable outcomes in patients with OHCA.

vanbolnički srčani zastoj, resuscitacija, povratak spontane cirkulacije, EuReCa registar

out-of-hospital cardiac arrest, resuscitation, return of spontaneous circulation, EuReCa registry

612(043.3)

Kardiologija

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