Prediktori pojave šokabilnog ritma i povrataka spontane cirkulacije kod pacijenata sa osvjedočenim srčanim zastojem
Ključne reči:
OHCA, šokabilni ritam, ROSC, EuReCa, prediktori
Sažetak
Uvod: Vanbolnički srčani zastoj (OHCA) predstavlja globalni zdravstveni izazov sa prosečnom stopom preživljavanja od 8%. Ishodi zavise od faktora kao što su lokacija, vreme do povratka spontane cirkulacije (ROSC), demografske karakteristike pacijenata i tip inicijalnog srčanog ritma.
Materijal i metode: EuReCa_Srbija je deo studije EuReCa ONE o preživljavanju nakon vanbolničkog srčanog zastoja (OHCA) u Evropi. Uključeni su slučajevi OHCA koje su zbrinjavale ekipe hitne medicinske pomoći (HMP), uključujući pedijatrijske i nekardiogene slučajeve. Podaci su prikupljani prema protokolu EuReCa ONE u periodu od 1. oktobra 2014. do 31. decembra 2021. godine.
Rezultati: Ispitivali smo prediktore za šokabilni inicijalni ritam, ROSC i prijem u bolnicu koristeći univarijabilnu i multivarijabilnu binarnu logističku regresiju. OHCA u područjima sa više od 100.000 stanovnika i u domovima pacijenata imali su značajno manju verovatnoću za šokabilni ritam (57,4% i 65,4% manje), dok su mlađa životna dob i kardiogeni uzrok povećavali verovatnoću (1,7 i 8,5 puta više). Šokabilni ritam je značajni prediktor za ROSC, povećavajući verovatnoću 3,9 puta, a za ROSC pri prijemu u bolnicu 3,3 puta. Urbanizovane i stambene lokacije smanjivale su šanse za ROSC za 55,8% i 51,1%. Pomoć dispečera HMP povećala je verovatnoću za ROSC pri prijemu u bolnicu 1,7 puta, dok je kašnjenje od 10 ili više minuta od poziva HMP do defibrilacije smanjilo verovatnoću za 86,1%.
Reference
1. Gräsner JT, Wnent J, Herlitz J, Perkins GD, Lefering R, Tjelmeland I, et al. Survival after out-of-hospital cardiac arrest in Europe - Results of the EuReCa TWO study. Resuscitation. 2020 Mar 1;148:218-226. doi: 10.1016/j.resuscitation.2019.12.042. Epub 2020 Feb 3. PMID: 32027980.
2. Yan S, Gan Y, Jiang N, Wang R, Chen Y, Luo Z, Zong Q et al. The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. Crit Care. 2020 Feb 22;24(1):61. doi: 10.1186/s13054-020-2773-2. PMID: 32087741; PMCID: PMC7036236
3. Barry T, Kasemiire A, Quinn M, Deasy C, Bury G, Masterson S. et al. Out-of-Hospital Cardiac Arrest Registry Steering Group. Resuscitation for out-of-hospital cardiac arrest in Ireland 2012-2020: Modelling national temporal developments and survival predictors. Resusc Plus. 2024 Apr 18;18:100641. doi: 10.1016/j.resplu.2024.100641. PMID: 38646094; PMCID: PMC11031785.
4. Nikolovski S S, Lazic A D, Fiser Z Z, et al. (October 06, 2021) Initial Outcomes and Survival of Out-of-Hospital Cardiac Arrest: EuReCa Serbia Multicenter Cohort Study. Cureus 13(10): e18555. DOI 10.7759/cureus.18555
5. Martinell L, Nielsen N, Herlitz J, et al. Early predictors of poor outcome after out-of-hospital cardiac arrest. Crit Care 2017;21:96.
6. Kreutz J, Patsalis N, Müller C, Chatzis G, Syntila S, Sassani K. et al. EPOS-OHCA: Early Predictors of Outcome and Survival after non-traumatic Out-of-Hospital Cardiac Arrest. Resusc Plus. 2024 Jul 24;19:100728. doi: 10.1016/j.resplu.2024.100728. PMID: 39157414; PMCID: PMC11327594.
7. Randjelovic S, Nikolovski S, Selakovic D, Sreckovic M, Rosic S, Rosic G. et al. Time Is Life: Golden Ten Minutes on Scene–EuReCa_Serbia 2014–2023. Medicina. 2024; 60(4):624. https://doi.org/10.3390/medicina60040624
8. Tateishi, K., Saito, Y., Yasufuku, Y. et al. Prehospital predicting factors using a decision tree model for patients with witnessed out-of-hospital cardiac arrest and an initial shockable rhythm. Sci Rep 13, 16180 (2023). https://doi.org/10.1038/s41598-023-43106-w
9. Podrid, P.J. Prognosis and outcomes following sudden cardiac arrest in adults. In UpToDate; Post, T.W., Ed.; Wolters Kluwer: Waltham, MA, USA, 2022.
10. Gräsner JT, Herlitz J, Tjelmeland IBM, Wnent J, Masterson S, Lilja G. et al European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe. Resuscitation. 2021 Apr;161:61-79. doi: 10.1016/j.resuscitation.2021.02.007. Epub 2021 Mar 24. PMID: 33773833
11. Petravic ́, L.; Miklicˇ, R.; Burger, E.; Keše, U.; Kulovec, D.; Poljanšek, E. et al. Enhancing Bystander Intervention: Insights from the Utstein Analysis of Out-of-Hospital Cardiac Arrests in Slovenia. Medicina 2024, 60, 1227.https://doi.org/10.3390/ medicina60081227
12. Strnad, M.; Borovnik Lesjak, V.; Jerot, P.; Esih, M. Prehospital Predictors of Survival in Patients with Out-of-Hospital Cardiac Arrest. Medicina2023,59,1717. https:// doi.org/10.3390/medicina59101717
13. Randjelovic SS, Nikolovski SS, Tijanic JZ, Obradovic IA, Fiser ZZ, Lazic AD, Raffay VI. Out-of-Hospital Cardiac Arrest Prospective Epidemiology Monitoring during the First Five Years of EuReCa Program Implementation in Serbia. Prehosp Disaster Med. 2023 Jan 5;38(1):1-8. doi: 10.1017/S1049023X22002424. Epub ahead of print. PMID: 36600667; PMCID: PMC9885433
14. Holmström L, Reinier K, Toft L, Halperin H, Salvucci A, Jui J. et al. Out-of-hospital cardiac arrest with onset witnessed by emergency medical services: Implications for improvement in overall survival. Resuscitation. 2022 Jun;175:19-27. doi: 10.1016/j.resuscitation.2022.04.003. Epub 2022 Apr 11. PMID: 35421535; PMCID: PMC10306322.
15. Gowens P, Smith K, Clegg G, Williams B, Nehme Z. Global variation in the incidence and outcome of emergency medical services witnessed out-of-hospital cardiac arrest: A systematic review and meta-analysis. Resuscitation. 2022 Jun;175:120-132. doi: 10.1016/j.resuscitation.2022.03.026. Epub 2022 Mar 30. PMID: 35367317.
16. Oving I, de Graaf C, Karlsson L, Jonsson M, Kramer-Johansen J, Berglund E. et al. Occurrence of shockable rhythm in out-of-hospital cardiac arrest over time: A report from the COSTA group. Resuscitation. 2020 Jun;151:67-74. doi: 10.1016/j.resuscitation.2020.03.014. Epub 2020 Apr 8. PMID: 32278017.
17. Awad E, Humphries K, Grunau B, Besserer F, Christenson J. The effect of sex and age on return of spontaneous circulation and survival to hospital discharge in patients with out of hospital cardiac arrest: A retrospective analysis of a Canadian population. Resusc Plus. 2021 Feb 6;5:100084. doi: 10.1016/j.resplu.2021.100084. PMID: 34223350; PMCID: PMC8244242.
18. Chia MYC, Kwa TPW, Wah W, Yap S, Doctor NE, Ng YY,. et al. Comparison of Outcomes and Characteristics of Emergency Medical Services (EMS)-Witnessed, Bystander-Witnessed, and Unwitnessed Out-of-Hospital Cardiac Arrests in Singapore. Prehosp Emerg Care. 2019 Nov-Dec;23(6):847-854. doi: 10.1080/10903127.2019.1587124. Epub 2019 Mar 27. PMID: 30795712.
19. De Maio VJ, Stiell IG, Wells GA, Spaite DW. Cardiac arrest witnessed by emergency medical services personnel: descriptive epidemiology, prodromal symptoms, and predictors of survival. OPALS study group. Ann Emerg Med. 2000 Feb;35(2):138-46. PMID: 10650231.
20. Emoto R, Nishikimi M, Shoaib M, Hayashida K, Nishida K, Kikutani K. et al. Prediction of Prehospital Change of the Cardiac Rhythm From Nonshockable to Shockable in Out-of-Hospital Patients With Cardiac Arrest: A Post Hoc Analysis of a Nationwide, Multicenter, Prospective Registry. J Am Heart Assoc. 2022 Jun 21;11(12):e025048. doi: 10.1161/JAHA.121.025048. Epub 2022 Jun 14. PMID: 35699202; PMCID: PMC9238669.
2. Yan S, Gan Y, Jiang N, Wang R, Chen Y, Luo Z, Zong Q et al. The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. Crit Care. 2020 Feb 22;24(1):61. doi: 10.1186/s13054-020-2773-2. PMID: 32087741; PMCID: PMC7036236
3. Barry T, Kasemiire A, Quinn M, Deasy C, Bury G, Masterson S. et al. Out-of-Hospital Cardiac Arrest Registry Steering Group. Resuscitation for out-of-hospital cardiac arrest in Ireland 2012-2020: Modelling national temporal developments and survival predictors. Resusc Plus. 2024 Apr 18;18:100641. doi: 10.1016/j.resplu.2024.100641. PMID: 38646094; PMCID: PMC11031785.
4. Nikolovski S S, Lazic A D, Fiser Z Z, et al. (October 06, 2021) Initial Outcomes and Survival of Out-of-Hospital Cardiac Arrest: EuReCa Serbia Multicenter Cohort Study. Cureus 13(10): e18555. DOI 10.7759/cureus.18555
5. Martinell L, Nielsen N, Herlitz J, et al. Early predictors of poor outcome after out-of-hospital cardiac arrest. Crit Care 2017;21:96.
6. Kreutz J, Patsalis N, Müller C, Chatzis G, Syntila S, Sassani K. et al. EPOS-OHCA: Early Predictors of Outcome and Survival after non-traumatic Out-of-Hospital Cardiac Arrest. Resusc Plus. 2024 Jul 24;19:100728. doi: 10.1016/j.resplu.2024.100728. PMID: 39157414; PMCID: PMC11327594.
7. Randjelovic S, Nikolovski S, Selakovic D, Sreckovic M, Rosic S, Rosic G. et al. Time Is Life: Golden Ten Minutes on Scene–EuReCa_Serbia 2014–2023. Medicina. 2024; 60(4):624. https://doi.org/10.3390/medicina60040624
8. Tateishi, K., Saito, Y., Yasufuku, Y. et al. Prehospital predicting factors using a decision tree model for patients with witnessed out-of-hospital cardiac arrest and an initial shockable rhythm. Sci Rep 13, 16180 (2023). https://doi.org/10.1038/s41598-023-43106-w
9. Podrid, P.J. Prognosis and outcomes following sudden cardiac arrest in adults. In UpToDate; Post, T.W., Ed.; Wolters Kluwer: Waltham, MA, USA, 2022.
10. Gräsner JT, Herlitz J, Tjelmeland IBM, Wnent J, Masterson S, Lilja G. et al European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe. Resuscitation. 2021 Apr;161:61-79. doi: 10.1016/j.resuscitation.2021.02.007. Epub 2021 Mar 24. PMID: 33773833
11. Petravic ́, L.; Miklicˇ, R.; Burger, E.; Keše, U.; Kulovec, D.; Poljanšek, E. et al. Enhancing Bystander Intervention: Insights from the Utstein Analysis of Out-of-Hospital Cardiac Arrests in Slovenia. Medicina 2024, 60, 1227.https://doi.org/10.3390/ medicina60081227
12. Strnad, M.; Borovnik Lesjak, V.; Jerot, P.; Esih, M. Prehospital Predictors of Survival in Patients with Out-of-Hospital Cardiac Arrest. Medicina2023,59,1717. https:// doi.org/10.3390/medicina59101717
13. Randjelovic SS, Nikolovski SS, Tijanic JZ, Obradovic IA, Fiser ZZ, Lazic AD, Raffay VI. Out-of-Hospital Cardiac Arrest Prospective Epidemiology Monitoring during the First Five Years of EuReCa Program Implementation in Serbia. Prehosp Disaster Med. 2023 Jan 5;38(1):1-8. doi: 10.1017/S1049023X22002424. Epub ahead of print. PMID: 36600667; PMCID: PMC9885433
14. Holmström L, Reinier K, Toft L, Halperin H, Salvucci A, Jui J. et al. Out-of-hospital cardiac arrest with onset witnessed by emergency medical services: Implications for improvement in overall survival. Resuscitation. 2022 Jun;175:19-27. doi: 10.1016/j.resuscitation.2022.04.003. Epub 2022 Apr 11. PMID: 35421535; PMCID: PMC10306322.
15. Gowens P, Smith K, Clegg G, Williams B, Nehme Z. Global variation in the incidence and outcome of emergency medical services witnessed out-of-hospital cardiac arrest: A systematic review and meta-analysis. Resuscitation. 2022 Jun;175:120-132. doi: 10.1016/j.resuscitation.2022.03.026. Epub 2022 Mar 30. PMID: 35367317.
16. Oving I, de Graaf C, Karlsson L, Jonsson M, Kramer-Johansen J, Berglund E. et al. Occurrence of shockable rhythm in out-of-hospital cardiac arrest over time: A report from the COSTA group. Resuscitation. 2020 Jun;151:67-74. doi: 10.1016/j.resuscitation.2020.03.014. Epub 2020 Apr 8. PMID: 32278017.
17. Awad E, Humphries K, Grunau B, Besserer F, Christenson J. The effect of sex and age on return of spontaneous circulation and survival to hospital discharge in patients with out of hospital cardiac arrest: A retrospective analysis of a Canadian population. Resusc Plus. 2021 Feb 6;5:100084. doi: 10.1016/j.resplu.2021.100084. PMID: 34223350; PMCID: PMC8244242.
18. Chia MYC, Kwa TPW, Wah W, Yap S, Doctor NE, Ng YY,. et al. Comparison of Outcomes and Characteristics of Emergency Medical Services (EMS)-Witnessed, Bystander-Witnessed, and Unwitnessed Out-of-Hospital Cardiac Arrests in Singapore. Prehosp Emerg Care. 2019 Nov-Dec;23(6):847-854. doi: 10.1080/10903127.2019.1587124. Epub 2019 Mar 27. PMID: 30795712.
19. De Maio VJ, Stiell IG, Wells GA, Spaite DW. Cardiac arrest witnessed by emergency medical services personnel: descriptive epidemiology, prodromal symptoms, and predictors of survival. OPALS study group. Ann Emerg Med. 2000 Feb;35(2):138-46. PMID: 10650231.
20. Emoto R, Nishikimi M, Shoaib M, Hayashida K, Nishida K, Kikutani K. et al. Prediction of Prehospital Change of the Cardiac Rhythm From Nonshockable to Shockable in Out-of-Hospital Patients With Cardiac Arrest: A Post Hoc Analysis of a Nationwide, Multicenter, Prospective Registry. J Am Heart Assoc. 2022 Jun 21;11(12):e025048. doi: 10.1161/JAHA.121.025048. Epub 2022 Jun 14. PMID: 35699202; PMCID: PMC9238669.
Objavljeno
2025/02/12
Kako citirati
Ristić, J., Medić, S., Lazić, A., Ranđelović , S., Šušković Bosančić , R., Bandulaja, M., & Vasilić, M. (2025). Prediktori pojave šokabilnog ritma i povrataka spontane cirkulacije kod pacijenata sa osvjedočenim srčanim zastojem. Journal Resuscitatio Balcanica, 9(21), 407 - 414. https://doi.org/10.5937/jrb9-53674
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