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2018, vol. 4, br. 10, str. 103-107
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EuReCa_Serbia - koliko smo napredovali?
EuReCa_Serbia: How far we have progressed?
Sažetak
Cilj: Cilj rada je da poređenjem podataka prikupljenih tokom odvijanja programa EuReCa utvrdi uticaj istog na kvalitet zbrinjavanja iznenadnog srčanog zastoja u sredinama obuhvaćenim programom. Metod: Program EuReCa je prospektivna, opservaciona, multicentrična studija koja je zavedena pod kliničkim tijalom pod brojem Clinical Trials ID: NCT03130088. Putem jedistvenog upitnika registruju se EuReCa događaji pacijenata sa vanbolničkim srčanim zastojem kod kojih je intervenisala HMP. Glavni istraživači ustanova koje učestvuju u projektu unuse podatke o EuReCa događajima u bazu putem adrese www.eureca.rs. Standardnim statističkim metodama su obrađivani podaci. a obuhvaćen je period od 1. oktobara 2014. do 1. avgusta 2017. Rezultati: U periodu koje istraživanje obuhvata registrovano je 4172 EuReCa događaja. Mere kardiopulmonalne resuscitacije (KPR) primenjene su kod 1618/4172 ili 37,78% od svih zabeleženih događaja. Mere KPR su tokom 2014 godine primenjene kod 465/1490 što iznosi 31,2% , tokom 2015 kod 469/1366 odn. 34,3%, 2016 kod 473/952 odn. 49,7% i 2017. godine 211/365 odn. 58%. Šokabilni inicijalni ritam (vetrikularna tahikardija bez pusa VT /ventrikularna fibrilacija VF) je u 2014. godini zabeležen kod 80 pacijenata od 465 primenjenih resuscitacija (17,20%), u 2015. godini 88/469 ili 18,76%, tokom 2016. godine 111/473 ili (23,47%) a tokom 2017. zabeleženo je 60/211 šokabilnih inicijalnih ritmova (28,44%). Povratak spontane cirkulacije (ROSC) je postignut u 2014. godini kod 16,12 % pacijenata 75/465 a 2017. kod 23,70% pacijenata odn. kod 50/211. Do otpusta iz bolnice ukupno je u posmatranom periodu preživelo 63/1618 (3,89%). Posmatrano po godinama 2014. je otpušteno iz bolnice 15/465 (3,23%) pacijenata, 2015. godine 18/469 (3,84), 2016. je otpušteno 20/473 pacijenata (4,23), a poslednje posmatrane godine 10/211odn. (4,74%). Preživljavanje do 30 dana beležimo kod 7/465 odn. (1,15%) pacijenata tokom 2014. a 2017. kod 7/211 što je 3,32% pacijenata. Zaključak: Rezultati programa nedvosmisleno ukazuju na značajne promene u preživljavanju pacijenata zatečenih u vanbolničkom srčanom zastoju tokom beleženja podataka u programu EuReCa. U narednom periodu treba objasniti koji su sve faktori doprineli promeni, poboljšanju rezultata zbrinjavanja srčanog zastoja izvan bolnice i zdravstvenih ustanova.
Abstract
Aim: The aim of this paper was to compare the collected data's during EuReCa project and to appoint the influence of it to the quality management of the cardiac arrest in participating areas. Methodology: The project EuReCa is a part of a metacentric, observational, prospective study of an observational trail of the European Resuscitation Council registered Clinical Trial NCT02236819 and approved by the US healthcare authorities. The data's from the Serbian cardiac arrest registry has been analyzed in period of 1st of October 2014 until 1st of August 2017 from www.eureca.rs application. Results: In the observed period, 4172 EuReCa events have been registered. Cardiopulmonary resuscitation (CPR) is performed in 1618/4172 or 37,78% of all cases. CPR in 2014 apply in 465/1490 cases (31,2%) , during 2015 in 469/1366 (34,3%), in 2016 at 473/952 (49,7%) and for 2017. in 211/365 (58%) cases. The initial shockable rhythm (pulseless ventricular tachycardia pVT /ventricular fibrillation VF) during 2014 was present at 80 patients out of 465 ongoing CPR's (17,20%), in 2015. 88/469 (18,76%), during 2016 111/473 (23,47%) and in 2017 the figures are 60/211 (28,44%). Return of spontaneous circulation (ROSC) was achieved in 2014 at 75/465 (16,12 %) and during 2017 in 50/211 (23,70%) patients. The hospital discharge in observed period was 63/1618 (3,89%), where 15/465 (3,23%) goes for 2014, 18/469 (3,84) for 2015, 20/473 (4,23) for 2016 and 10/211 (4,74%) in 2017. The 30-days survival rate was 7/465 (1,15%) in 2014 and 7/211(3,32%) patients in 2017. Conclusion: The results unambiguously indicate significant increase in survival rate in patients with out-of-hospital cardiac arrest registered in EuReCa database. In the forthcoming period, the focus will be directed into the contributing factors that lead to the improvement in end-results of outs-of hospital cardiac arrest management and healthcare centers'.
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