EuReCa_Srbija 2014-2023 Vreme od poziva do dolaska na mesto zadesa - uticaj na započinjanje mera KPR
Sažetak
Uvod: Udeo ne-započinjanja mera kardiopulmonalne resuscitacije (KPR) kod pacijenata sa vanbolničkim srčanim zastojem (VBSZ) ima širok opseg među različitim zemljama, sa ograničenim nalazima u literaturi koji se bave faktorima povezanim sa većim udelom ne-započinjanja, naročito kada je u pitanju reakciono vreme (RV) ekipe hitne medicinske pomoći. Cilj ove studije je analiza podataka o dužini RV u odnosu na započinjanje, odnosno ne-započinjanje mera KPR, uz uključivanje lokacije zadesa, etiologije VBSZ I starosti pacijenta kao dodatnih faktora potencijalno povezanih sa učestalošću ne-započinjanja istih mera.
Materijali Metode: U ovoj studiji analizirani su podaci o započinjanju, odnosno ne-započinjanju primene KPR mera, dužini RV, lokaciji zadesa, etiologiji VBSZ I starosti pacijenata prikupljani prema protokolu EuReCa studije tokom perioda 1.oktobar 2014.-31.decembar 2023. godine.
Rezultati: U ispitivanom period zabeleženo je ukupno 10458 EuReCa događaja sa medijanom RV od 9 (IQR 5-17) minuta. U 6197/10458 slučajeva (59, 3%) KPR mere nisu bile započete. Statistički značajno duže RV uočeno je u grupi pacijenata kod kojih KPR mere nisu bile započete u poređenju sa slučajevima gde su iste bile primenjene (Med = 25 (IQR 10-45) vs. Med = 6 (IQR 4-10) minuta, respektivno; p<0,001).U odnosu na lokaciju, i u grupi sa započetim i u grupi sa nezapočetim merama KPR, statistički kraće RV je uočeno kada se zades dogodio na javnom mestu u poređenju sa mestom stanovanja pacijenta (p<0,001), kao i pri poređenju sa ostalim lokacijama zadesa (p<0,001). U pogledu etiologije, značajno kraće RV je uočeno u grupi gde KPR mere nisu bile započete, i to pri komparaciji grupe pacijenata sa traumatskim VBSZ u poređenju sa VBSZ kardiogene etologije (p<0,001) I ostalih etioloških kategorija VBSZ (p=0,001). Među pojedinim starosnim kategorijama, značajne razlike u dužini RV uočene su i u grupi pacijenata gde KPR mere nisu bile započete (H=83,553; p<0,001), ali i u grupi pacijenata gde su navedene mere bile započete (H=21,260; p=0,012).
Zaključak: Reakciono vreme ekipe HMP je značajno duže u slučajevima kada se mere KPR ne primenjuju. Javno mesto kao lokacija zadesa, pojedini etiološki faktori i starosne grupe pacijenata su bili značajno povezani sa kraćim RV, što može ukazivati na potencijalne faktore koji doprinose produžetku istog u slučajevima kada se KPR mere ne primenjuju. Neophodne su dodatne analize koje će utvrditi uzročno-posledičnu vezu između dužine RV i učestalosti započinjanja, odnosno ne-započinjanja KPR mera, kao i uticaj drugih potencijalnih faktora sa ciljem povećanja šanse preživljavanja nakon VBSZ.
Reference
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