دورية أكاديمية

Influence of patient body weight on the probability of return of spontaneous circulation following out-of-hospital cardiac arrest: an exploratory analysis.

التفاصيل البيبلوغرافية
العنوان: Influence of patient body weight on the probability of return of spontaneous circulation following out-of-hospital cardiac arrest: an exploratory analysis.
المؤلفون: Hubble, Michael W., Kaplan, Ginny R., Martin, Melisa
المصدر: British Paramedic Journal; Sep2024, Vol. 9 Issue 2, p11-20, 10p
مصطلحات موضوعية: T-test (Statistics), BODY weight, PROBABILITY theory, SEX distribution, FISHER exact test, LOGISTIC regression analysis, RETROSPECTIVE studies, DEFIBRILLATORS, CHI-squared test, EMERGENCY medical services, BYSTANDER CPR, ODDS ratio, RESEARCH, STATISTICS, CARDIAC arrest, RETURN of spontaneous circulation, DATA analysis software, REGRESSION analysis
مستخلص: Introduction: In addition to key interventions, including bystander CPR and defibrillation, successful resuscitation of out-of-hospital cardiac arrest (OHCA) is also associated with several patient-level factors, including a shockable presenting rhythm, younger age, Caucasian race and female sex. An additional patient-level factor that may influence outcomes is patient weight, yet this attribute has not been extensively studied within the context of OHCA, despite globally increasing obesity rates. Objective: To assess the relationship between patient weight and return of spontaneous circulation (ROSC) during OHCA. Methods: This retrospective study included adult patients from a national emergency medical services (EMS) patient record, with witnessed, non-traumatic OHCA prior to EMS arrival from January to December 2020. Logistic regression was used to evaluate the relationship between patient weight and ROSC. Results: Complete records were available for 9096 patients, of which 64.3% were males and 25.3% were ethnic minorities. The mean age of the participants was 65.01 years (SD = 15.8), with a mean weight of 93.52 kg (SD = 31.5). Altogether, 81.8% of arrests were of presumed cardiac aetiology and 30.3% presented with a shockable rhythm. Bystander CPR and automated external defibrillator (AED) shock were performed in 30.6% and 7.3% of cases, respectively, and 44.0% experienced ROSC. ROSC was less likely with patient weight >100 kg (OR = 0.709, p <0.001), male sex (OR = 0.782, p <0.001), and increasing age and EMS response time (OR = 0.994 per year, p <0.001 and OR = 0.970 per minute, p <0.001, respectively). Patients with shockable rhythms were more likely to achieve ROSC (OR = 1.790, p <0.001), as were patients receiving bystander CPR (OR = 1.170, p <0.001) and defibrillation prior to EMS arrival (OR = 1.658, p <0.001). Although the mean first adrenaline dose (mg/kg) followed a downward trend due to its non-weight-based dosing scheme, the mean total adrenaline dose administered to achieve ROSC demonstrated an upward linear trend of 0.05 mg for every 5 kg of body weight. Conclusions: Patient weight was negatively associated with ROSC and positively associated with the total adrenaline dose required to attain ROSC. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:14784726
DOI:10.29045/14784726.2024.9.9.2.11