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2019, vol. 5, br. 14, str. 198-205
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Introducing the Crimean out-of-hospital cardiac arrest and resuscitation registry (COHCARR): Rationale, design and 6-month baseline data
(naslov ne postoji na srpskom)
aV. I. Vernadsky Crimean Federal University, Medical Academy named after S. I. Georgievsky, Simferopol, Russian Federation bCrimean Republican Center for Disaster Medicine and Emergency Medical Services, Simferopol, Russian Federation
e-adresa: birkunalexei@gmail.com
Sažetak
Uvod: Postoji potreba za uspostavljanjem registara za vanbolnički srčani zastoj (OHCA) u zemljama bivšeg Sovjetskog Saveza. Ovaj članak ima za cilj pružiti obrazloženje i opisati metodologiju krimskog registra vanbolničkog srčanog zastoja i oživljavanja (COHCARR), te izvijestiti osnovne podatke o epidemiologiji OHCA i hitnoj medicinskoj službi (EMS) u Republici Krim. Metode: COHCARR je zamišljen kao potencijalni populacijski registar svih slučajeva OHCA-e koji su prisustvovali EMS-u sa pokušajima oživljavanja koji se događaju u Republici Krim. Pokrivenost stanovništva je 1,91 miliona (100% stanovnika republike). Osnovna opisna analiza OHCA s pokušajem reanimacije (1. siječnja-30. lipnja 2018.) provedena je po Utstein metodologiji kako bi se dao sažetak problema OHCA u regiji. Rezultati: U tom periodu, EMS je prisustvovalo ukupno 6391 OHCA. S tim je reanimacija pokušana samo u 196 slučajeva (3,1%; srednja dob 65 godina, muškarci 56%, šokantna 16%). Većina (95%) svjedočila je EMS ili prolaznik. Od slučajeva svjedoka koji su prolazili (24%, n = 47), pokušaj reanimacije pokušao je u 19% (n = 9). Povratak spontane cirkulacije (ROSC) postignut je u 6,6% bolesnika, a 5,6% je preživelo prijem u bolnicu. Zaključci: Niske stope pokušaja oživljavanja, ROSC i preživljavanje do prijema u bolnicu nalažu priliku za poboljšanje ishoda OHCA na Krimu. Registar će pomoći ciljanju razumnih isplativih intervencija i procjeni njihove učinkovitosti u regiji. COHCARR može poslužiti kao osnovni model za izradu registra OHCA na drugim postsovjetskim teritorijama.
Abstract
Introduction: There is an urgent unmet need for establishing out-of-hospital cardiac arrest (OHCA) registries in the former Soviet Union countries. This article aims to provide a rationale and describe methodology of the Crimean out-of-hospital cardiac arrest and resuscitation registry (COHCARR), and report baseline information on OHCA epidemiology and emergency medical service (EMS) performance in the Republic of Crimea. Methods: COHCARR is designed to be a prospective population-based registry of all EMS-attended OHCA cases with resuscitation attempts, occurring in the Republic of Crimea. The population coverage is 1.91 million (100% inhabitants of the republic). The baseline descriptive analysis of OHCA with attempted resuscitation (January 01-June 30, 2018) has been performed following the Utstein methodology to provide a snapshot of OHCA problem in the region. Results: During the period, a total of 6,391 OHCA were attended by EMS. With that, resuscitation was attempted only in 196 cases (3.1%; median age 65 years, male 56%, shockable 16%). Most (95%) were witnessed by EMS or a bystander. Out of the bystander-witnessed cases (24%, n=47), bystander resuscitation was attempted in 19% (n=9). Return of spontaneous circulation (ROSC) was achieved in 6.6% patients, and 5.6% survived to hospital admission. Conclusions: The low rates of attempted resuscitation, ROSC and survival to hospital admission imply an opportunity to improve outcomes from OHCA in the Crimea. The registry will help to target reasonable cost-effective interventions and assess their effectiveness in the region. COHCARR may serve as a basic model for developing OHCA registries in other post-Soviet territories.
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