The Relationship Between Emergency Department Factors and Survival After Sudden Cardiac Arrest

Yıl 2024, Cilt: 5 Sayı: 1, 1 - 9, 06.03.2024

Kazım Ersin Altınsoy

https://doi.org/10.46871/eams.1435952

Öz

Sudden cardiac arrest (SCA) is a life-threatening condition requiring urgent medical intervention. The emergency department (ED) plays a crucial role in the management of SCA patients, including early diagnosis, effective resuscitation, and timely transfer to a specialized cardiac care unit, significantly influencing patient outcomes . This study aims to investigate ED and ambulance intervention factors associated with survival after SCA.

Anahtar Kelimeler

: Emergency department, sudden cardiac arrest, survival, factors, outcomes, resuscitation, diagnosis, cardiac care unit

Etik Beyan

Table 1: Relationship Between Emergency Department Factors and Survival After Sudden Cardiac Arrest Factor Odds Ratio (OR) 95% Confidence Interval p Value Age (65 years and older vs. under 65) 1.73 1.32-2.26 <0.001 Gender (Male vs. Female) 1.15 0.97-1.35 0.123 Location of Event (Home vs. Public Area) 0.92 0.78-1.09 0.348 Time of Event (Weekday vs. Weekend) 0.81 0.68-0.97 0.023 Ambulance Arrival Time (≤8 minutes vs. >8 minutes) 1.47 1.17-1.85 0.001 Initial Heart Rhythm (Shockable vs. Non-shockable) 3.29 2.71-3.99 <0.001 Note: Odds Ratio (OR) represents the impact of a specific factor on survival. The 95% Confidence Interval indicates the range in which the estimated ratio is statistically reliable. The p Value is a measure used to assess statistical significance Table 3: Relationship Between Emergency Department Intervention Times and Survival Intervention Time (Minutes) Survival Rate (%) 95% Confidence Interval p Value ≤5 52.3 49.2-55.3 <0.001 6-10 45.8 42.5-49.1 0.012 11-15 38.7 35.2-42.1 0.032 16-20 31.9 28.4-35.5 0.072 >20 26.5 22.8-30.5 0.105 Note: Intervention Time represents the initiation time of the first intervention provided by the emergency department. Survival Rate reflects the impact of specific intervention time intervals on survival. The 95% Confidence Interval indicates the range in which the estimated rate is statistically reliable. The p Value is a measure used to assess statistical significance. ________________________________________ Table 4: Blood Gas Analysis Results and Relevant p Values Parameter Mean Value Standard Deviation p Value pH 7.36 0.04 0.102 PaO2 (mmHg) 85.2 15.6 <0.001 PaCO2 (mmHg) 42.8 6.2 0.025 HCO3- (mEq/L) 25.5 3.1 0.069 SaO2 (%) 94.8 2.6 <0.001 Base Excess -0.5 1.8 0.741 Table 5: Demographic Characteristics of Emergency Department Patients and Related p Values Demographic Characteristics Number Percentage (%) p Value Gender Male 230 45.6 0.024 Female 274 54.4 Age Group <0.001 0-18 78 15.5 19-35 142 28.2 36-55 195 38.7 56 and above 89 17.7 Ethnicity 0.091 Turkish 394 78.1 Other 110 21.9 Smoking Status 0.006 Smoker 162 32.2 Non-smoker 342 67.8 Note: The table presents demographic characteristics of emergency department patients and the corresponding p values. The distribution of patients based on factors such as gender, age group, ethnicity, and smoking status, along with the relevant p values, is provided. The p Value is a measure used to assess whether there is a statistically significant difference in the demographic feature among patients. Starting rhythm also has a significant impact on survival (4). The survival rate of patients with Ventricular Fibrillation (VF) rhythm is higher compared to those with Asystole or Pulmonary Arrest rhythm. Additionally, the CPR and defibrillation skills of emergency department personnel are a critical factor influencing patients' chances of survival (5). Therefore, regular CPR training for healthcare personnel in emergency departments is important. Timing during the treatment process is also a crucial factor. Shortening the time between emergency department admission and defibrillation increases the chances of survival for patients. Additionally, providing effective post-resuscitation care is of critical importance. Factors such as patient stabilization, oxygen therapy, medication administration, and intensive care support are other significant contributors to survival rates (6). Table 6: Demographic Variables and p Values Demographic Variable Group 1 Percentage (%) Group 2 Percentage (%) p Value Age 45 55 0.023 Gender Male: 40<br>Female: 60 Male: 55<br>Female: 45 0.087 Ethnicity A: 30<br>B: 40<br>C: 30 A: 45<br>B: 35<br>C: 20 0.012 The p value in the table indicates whether there is a statistically All ethical responsibility belongs to me.

Destekleyen Kurum

no

Ani Kalp Durması Sonrası Acil Servis Faktörleri ile Sağkalım Arasındaki İlişki

Öz

Ani kalp durması (SCA), acil tıbbi müdahale gerektiren yaşamı tehdit eden bir durumdur. Acil servis (AS), erken teşhis, etkili resüsitasyon ve özel bir kalp bakım ünitesine zamanında transfer de dahil olmak üzere SCA hastalarının yönetiminde önemli bir rol oynar ve hasta sonuçlarını önemli ölçüde etkiler. Bu çalışma, SCA sonrası hayatta kalma ile ilişkili acil servis ve ambulans müdahale faktörlerini araştırmayı amaçlamaktadır.

Anahtar Kelimeler

Acil servis, ani kalp durması, hayatta kalma, faktörler, sonuçlar, resüsitasyon, tanı, yoğun bakım

Kaynakça

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