2024年杭州市公众启动除颤计划的实践数据分析OA

Objective To analyze the real-world effectiveness and influencing factors of public access defibrillation(PAD)to promote the rational configuration and scientific application of automated external defibrillator(AED)in public places and improve the success rate of out-of-hospital cardiac arrest(OHCA).Methods Hangzhou city 85 OHCA patients who received PAD were assigned to the experimental group,while those 3 598 patients treated solely by emergency medical services(EMS)during the same period constituted the control group.Comparisons were performed between the two groups in terms of the proportion of initial defibrillable rhythm and defibrillation success rate.The differences in treatment outcomes between patients with complete implementation of EMS clinical pathway and those with incomplete implementation were also compared.Multivariate analysis was used to explore the relevant influencing factors,and a continuous quality improvement plan was formulated.Results The proportion of shockable initial rhythms of the experimental group and the control group was 60.00%(51/85)and 12.34%(444/3 598)respectively,and the difference was statistically significant(P<0.05).The rate of return of spontaneous circulation(ROSC)and the survival and discharge rate of the experimental group were significantly higher than those of the control group[ROSC rate:70.59%(36/51)vs.26.58%(118/444),survival and discharge rate:47.06%(24/51)vs.12.16%(54/444),both P<0.05].The ROSC rate and survival discharge rate of the fully executed clinical path group were significantly high than the incomplete clinical path group[ROSC rate:46.71%(78/167)vs.23.19%(16/69),survival to discharge rate:23.35%(39/167)vs.11.59%(8/69),both P<0.05].Conclusions PAD is an important part of OHCA treatment.The further improvement of the success rate of OHCA treatment requires not only the rational allocation and scientific management of AED in public places,but also requires close cooperation between the public,pre-hospital and in-hospital services,as well as,EMS to standardize the implementation of clinical paths.