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논문 기본 정보

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학술저널
저자정보
Lim Daesung (Department of Emergency Medicine Gyeongsang National University College of Medicine Gyeongsang Nati) Park Song Yi (Department of Emergency Medicine Dong-A University College of Medicine Dong-A University Hospital B) Choi Byungho (Department of Emergency Medicine University of Ulsan College of Medicine Ulsan University Hospital) Kim Sun Hyu (Department of Emergency Medicine University of Ulsan College of Medicine Ulsan University Hospital) Ryu Ji Ho (Department of Emergency Medicine Pusan National University College of Medicine Pusan National Unive) Kim Yong Hwan (Department of Emergency Medicine Samsung Changwon Hospital Sungkyunkwan University School of Medici) Sung Ae Jin (Department of Emergency Medicine Gyeongsang National University Hospital Jinju Korea.) Bae Byung Kwan (Department of Emergency Medicine Pusan National University College of Medicine Pusan National Unive) Kim Han Byeol (Department of Emergency Medicine Inje University Haeundae Paik Hospital Busan Korea.)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.36 No.36
발행연도
2021.9
수록면
1 - 13 (13page)
DOI
10.3346/jkms.2021.36.e255

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Background: Since the declaration of the coronavirus disease 2019 (COVID-19) pandemic, COVID-19 has affected the responses of emergency medical service (EMS) systems to cases of out-of-hospital cardiac arrest (OHCA). The purpose of this study was to identify the impact of the COVID-19 pandemic on EMS responses to and outcomes of adult OHCA in an area of South Korea. Methods: This was a retrospective observational study of adult OHCA patients attended by EMS providers comparing the EMS responses to and outcomes of adult OHCA during the COVID-19 pandemic to those during the pre-COVID-19 period. Propensity score matching was used to compare the survival rates, and logistic regression analysis was used to assess the impact of the COVID-19 pandemic on the survival of OHCA patients. Results: A total of 891 patients in the pre-COVID-19 group and 1,063 patients in the COVID-19 group were included in the final analysis. During the COVID-19 period, the EMS call time was shifted to a later time period (16:00?24:00, P < 0.001), and the presence of an initial shockable rhythm was increased (pre-COVID-19 vs. COVID-19, 7.97% vs. 11.95%, P = 0.004). The number of tracheal intubations decreased (5.27% vs. 1.22%, P < 0.001), and the use of mechanical chest compression devices (30.53% vs. 44.59%, P < 0.001) and EMS response time (median [quartile 1-quartile 3], 7 [5?10] vs. 8 [6?11], P < 0.001) increased. After propensity score matching, the survival at admission rate (22.52% vs. 18.24%, P = 0.025), survival to discharge rate (7.77% vs. 5.52%, P = 0.056), and favorable neurological outcome (5.97% vs. 3.49%, P < 0.001) decreased. In the propensity score matching analysis of the impact of COVID-19, odds ratios of 0.768 (95% confidence interval [CI], 0.592?0.995) for survival at admission and 0.693 (95% CI, 0.446?1.077) for survival to discharge were found. Conclusion: During the COVID-19 period, there were significant changes in the EMS responses to OHCA. These changes are considered to be partly due to social distancing measures. As a result, the proportion of patients with an initial shockable rhythm in the COVID-19 period was greater than that in the pre-COVID-19 period, but the final survival rate and favorable neurological outcome were lower.
#Emergency Medical Services #Out-of-Hospital Cardiac Arrest #COVID-19

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참고문헌 (31)

참고문헌 신청
Hartley DM / 2020 / Public health interventions for COVID-19 : emerging evidence and implications for an evolving public health crisis / JAMA 323(19):1908~1909 google schola Lange SJ / 2020 / Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions—United States, January–May 2020. Wiley Online Library; 2020 / MMWR Morb Mortal Wkly Rep 69(25):795~800 google schola Sung Ho Kyung / 2021 / Impact of the COVID-19 Outbreak on Emergency Care Utilization in Patients with Acute Myocardial Infarction: a Nationwide Population-based Study / Journal of Korean Medical Science 36(16):1~11 dbpia Yoon Doran / 2021 / Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Medical Use of Military Hospitals in Korea / Journal of Korean Medical Science 36(28):1~11 dbpia Baldi E / 2020 / Out-of-hospital cardiac arrest during the Covid-19 outbreak in Italy / N Engl J Med 383(5):496~498 google schola

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