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2017, vol. 3, br. 8, str. 53-57
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Povratak spontane cirkulacije kod pacijenata srčanog zastoja kardiološke etiologije u populaciji odraslih u Srbiji
Rosc in out-of-hospital cardiac arrest patients by cardiologic etiology in the adult population in Serbia
aSlužba Hitne medicinske pomoći, Dom zdravlja Subotica, Subotica bZavod za Hitnu medicinsku pomoć Novi Sad, Novi Sad cResuscitacioni Savet Srbije
e-adresa: dzsupiar@gmail.com
Sažetak
Cilj: Utvrđivanje epidemiologije srčanog zastoja kardiološke etiologije kod pacijenata starijih od 18 godina u Srbiji, svrstanih u tri starosne kategorije. Metodologija: Analizirani su podaci prikupljeni iz prospektivne studije, observacionog trijala Evropskog Resuscitacionog Saveta koji je pod brojem NCT02236819 registrovan u bazi trijala i odobren od zdravstvenih autoriteta u SAD. Podatke u registar srčanog zastoja EuReCa Srbija su unosili glavni istraživači svake ustanove u jedinstvenu bazu putem onlajn unosa (www.eureca.rs). U analizu su uključeni svi pacijenti stariji od 18 godina kod kojih su sprovedene mere kardiopulmonalne resuscitacije od strane Službe hitne medicinske pomoći u periodu od 1. januara 2017. godine do 01. avgusta 2017. Pacijenti su podeljeni u tri grupe: prva grupa 18-65 godina, druga grupa 66-80 i treća grupa osobe preko 80 godina. Za obradu podataka je korišten program Statistika. Rezultati: U periodu od 1.10.2014. godine do 1.08.2017. godine, u Srbiji je registrovano 3153 osoba sa srčanim zastojem. Mere kardiopulmonalne resuscitacije su započete kod 1385/3153 (44%). Tokom posmatranog perioda, registrovano je 593/1385 (43%) pacijenta ≥18 godina koji su doživeli vanbolnički srčani zastoj i kod kojih su primenjene mere kardiopulmonalne resuscitacije kardiološkog etiološkog uzroka, a koji nije svedočen od strane službe hitne medicinske pomoći. U grupi 18-65 godina srčani zastoj imalo 271/593 (46%), u grupi između 66-80 godina VBSZ je imalo 239/593 (40%) i osobe preko 80 godina, 83/593 (14%). U grupi od 18 do 65 godina, svedok je bio prisutan 243/271 puta (89.6%), u grupi 66-80 godina svedok je prisustvovao 222/239 (92%) slučaja, dok je preko 80 godina osvedočeno 76/83 (91.5%). Incicijalni ritam VF/VT bez pulsa je u kategoriji 18-65 bio 94/271 (34.6%), u grupi 66-80 šokabilni inicijalni ritam je 66/239 (27.6%), dok je preko 80 godina 13/83 (15.6%). Povratak spontane cirkulacije (ROSC) je postignut kod osoba 18-65 godina 68/271 (25%), u grupi 66-80 kod 57/239 (23.8%), a preko 80 god. 13/83 (15.6%). Do otpusta je preživelo 10/271 (3.6%) starosti 18-65 godina, od 66-80 godina 12/239 (5.0%) a preko 80 god. 2/83 (2.4%). Više od 30 dana od otpusta je preživelo 10/271 (3.7%) u kategoriji 18-65 godina, starosti 66-80 godina 11/239 (4.6%), dok je preko 80 godina preživelo 2/83 (2.4%). Zaključak: Postoji značajna razlika u preživljavanju vanbolničkog srčanog zastoja između pojedinih, ovim istraživanjem definisanih starosnih struktura stanovništva. Podaci o značajno većem preživljavanju (4-6 puta) najstarijih kategorija stanovništva, u odnosu na one od 18-65 godina, zahtevaju dalja istraživanja i pokašaje boljeg razumevanja razloga za navedeno.
Abstract
Aim: Determination of epidemiology of cardiac arrest by cardiologic etiology in patients older than 18 years in Serbia, classified into three age groups Methodology: The analyzed data's are collected from the prospective study, an observational trial of the European Resuscitation Council under the number NCT02236819, registered in the trial database and approved by the health authorities in the United States. Datas' in the EuReCa Serbia Cardiac Arrest Register has been entered by the lead investigators of each institution into a unique database via online entry (www.eureca.rs). The analysis included all patients over 18 years of age who underwent cardiopulmonary resuscitation by the Emergency Medical Service in the period from 1 January 2017 to 1 August 2017. Patients are divided into three groups: first group 18-65 years; the second group 66-80 and the third group is over 80 years. Statistics and Microsoft Excel 2016 program was used for data processing. Results: In the period of 1.10.2014 - 01.08.2017, 3153 patients with cardiac arrest were registered in Serbia. Cardiopulmonary resuscitation was started in 1385/3153 (44%). During the observed period, 593/1385 (43%) of patients ≥18 years who had out-of-hospital cardiac arrest with cardiologic etiology where cardiopulmonary resuscitation has been applied, and which was not testified by the emergency medical service. In the 18-65 age group, the cardiac arrest was present in 271/593 (46%), in the group between 66-80 years OHCA had 239/593 (40%) and in the group over 80, 83/593 (14%). In the 18-65 age group, witnesses were present 243/271 times (89.6%), in the 66-80 age group in 222/239 (92%) cases, while over 80 years ago, 76/83 (91.5 %). The initial rhythm VF / pVT in the 18-65 group was 94/271 (34.6%), in the group of 66-80, the initial shockable rhythm was 66/239 (27.6%), while over 80 years 13/83 (15.6% ). Return of spontaneous circulation (ROSC) was achieved in 68/271 (25%) in 18-65 age group, in the group of 66-80 in 57/239 (23.8%), and over 80 years. 13/83 (15.6%). Hospital discharge survival was 10/271 (3.6%) in the group of 18-65 years, among 66-80 years group was 12/239 (5.0%) and in the group over 80 years was 2/83 (2.4%). The rate of 30 days survival after hospital discharge was 10/271 (3.7%) in the 18-65 age group, 11/239 (4.6%) in group of 66-80 years and 2/83 (2.4%) in the group over 80 years. Conclusion: There is a significant difference in the survival of outpatient cardiac arrest between individuals, by exploring the age structure of the population. Data on significantly higher survival (4-6 times) of the oldest population categories, compared to those aged 18-65, require further investigations which will lead to deeper insights of the underlying reasons related to this topic.
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Reference
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Fišer, Z., Vlajović, S., Jakšić-Horvat, K., Raffay, V. (2015) EURECA Serbia ONE 2014: Out of hospital cardiac arrest: Venue of accident. Journal Resuscitatio Balcanica, vol. 1, br. 1, str. 9-11
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Grasner, J.T., Lefering, R., Koster, W.R., i dr. (2016) EuReCa ONE- 27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe. Resuscitation, 188-195; 105
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Institut za javno zdravlje Srbije 'dr Milan Jovanović Batut' (2016) Zdravstveno statistički godišnjak Republike Srbije, Beograd, 2015, http://www.batut.org.rs/download/publikacije/pub2015.pdf
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Republički zavod za statistiku (2017) Statistički godišnjak Republike Srbije, Beograd, http://webrzs.stat.gov.rs/WebSite/Public/PageView.aspx?p-Key=82
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Wissenberg, M., Folke, F., Hansen, C.M., Lippert, F.K., Kragholm, K., Risgaard, B., Rajan, S., Karlsson, L., Søndergaard, K.B., Hansen, S.M., Mortensen, R.N., Weeke, P., Christensen, E. (2015) Survival After Out-of-Hospital Cardiac Arrest in Relation to Age and Early Identification of Patients With Minimal Chance of Long-Term SurvivalCLINICAL PERSPECTIVE. Circulation, 131(18): 1536-1545
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