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KMID : 1148020220470010005
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조선대학교의대논문집
2022 Volume.47 No. 1 p.5 ~ p.12
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The response time and survival after witnessed outof- hospital cardiac arrest in smartphone-assisted advanced life support
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Hwang In-Hun
Kim Seong-Jung
Park Yong-Jin
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Abstract
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Introduction: It is unknown that ALS (advanced life support) directed by physician using real-time video call has a positive impact on survival outcomes in patients with bystander-witnessed out-of-hospital cardiac arrest (OHCA) even when the response time is prolonged.
Methods: The Smartphone-assisted Advanced Life Support (SALS) study group aims for better survival outcomes in OHCA in selected areas of South Korea. Demographic factors and time records of
EMTs were collected from the data on the Central Fire Services server and SALS application. The cut-off values for the response time intervals predicting the survival outcomes (ROSC, survival to discharge, favorable outcome) were assessed using Youden index in the Receiver operating characteristic (ROC) curve analysis. The adjusted odds ratios and 95% confidence intervals for outcomes were analyzed using multivariable logistic regression analysis that included all related variables predicting for survival outcomes in binary logistic regression model.
Results: Of 2283 adult OHCA with presumed cardiac etiology were analyzed between January 1, 2020 and December 31, 2020. The cut off value of response time was 7 minutes which predicted ROSC (return of spontaneous circulation), survival to discharge, and favorable neurologic outcome in patients with OHCA. SALS were independently associated with survival outcomes. The rates for survival to discharge and favorable neurologic outcomes were significantly higher in patients managed with SALS than in patients with BLS (basic life support) in both response time groups within 7 minutes and thereafter.
Conclusions: Performing SALS was strongly associated with better survival outcomes for bystander- witnessed OHCA patients. Furthermore, receiving ALS by this means had a positive impact on ROSC, survival to discharge, and CPC (cerebral performance category) 1, 2 even when the response time of EMTs was prolonged.
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KEYWORD
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Advanced life support, Cardiac arrest, Emergency medical system
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Listed journal information
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