Author/Editor     Grmec, Štefek; Križmarić, Miljenko; Mally, Štefan; Koželj, Anton; Špindler, Mateja; Lešnik, Bojan
Title     Utstein style analysis of out-of-hospital cardiac arrest-Bystander CPR and end expired carbon dioxide
Type     članek
Source     Resuscitation
Vol. and No.     Letnik 72, št. 3
Publication year     2007
Volume     str. 404-14
Language     eng
Abstract     Introduction: The aim of this prospective cohort study was to describe the outcome for patients with out-of-hospital cardiac arrest in Maribor (Slovenia) over a 4 year period using a modified Utstein style, and to investigate elementary knowledge of basic life support among potential bystanders in our community. Patients and methods: Through the prehospital and the hospital database system we followed up a consecutive group of patients with out-of-hospital cardiac arrest (OHCA) between January 2001 and December 2004. We investigated the effects of various factors on outcome in OHCA, especially partial end-tidal CO2 pressure petCO2, efficacy of bystander CPR and their elementary knowledge of basic life support (BLS). We also examined motivation among potential bystanders and possible implementation for BLS education in our community. Results: OHCA was confirmed in 592 patients. Advanced cardiac life support was initiated in 389 patients, of which 277 were of cardiac aetiology. In 287 patients the event was bystanders witnessed and lay-bystander basic life support was performed only in 83 (23%). After treating OHCA by a physician-based prehospital medical team ROSC was obtained in 61%, the ROSC on admission was 50% and the overall survival to discharge was 21%. Initial petCO(2) (OR: 22.04; 95%CI: 11.41-42.55), ventricular fibrillation or pulseless ventricular tachycardia asinitial rhythm (OR: 2.13; 95%CI: 1.17-4.22), bystander CPR (OR: 2.55; 95%CI:1.13-5.73), female sex (OR: 3.08; 95%CI: 1.49-6.38) and arrival time (OR: 1.29; 95%CI: 1.11-1.82) were associated with improved ROSC when using multivariate analysis. Using the same method we found that bystander CPR (OR: 5.05; 95% I: 2.24-11.39), witnessed arrest (OR: 9.98; 95%CI: 2.89-34.44), final petCO2 (OR: 2.37; 95%CI: 1.67-3.37), initial petCO2 (OR: 1.61; 95%CI: 1.28-2.64) and arrival time (OR: 1.39; 95%CI: 1.33-1.60) were associated with improved survival. (Abstract truncated at 2000 characters.)
Descriptors     CARDIOPULMONARY RESUSCITATION
SURVIVAL RATE
CARBON DIOXIDE
HEART ARREST
CAPNOGRAPHY
RESUSCITATION
TREATMENT OUTCOME