Características epidemiológicas de las paradas cardiorrespiratorias extrahospitalarias registradas porel sistema de emergencias 061 (SAMU) de la Comunidad Autónoma de las Islas Baleares (2009-2012) / Epidemiological characteristics of out-of-hospital cardiorespiratory arrest recorded by the 061 emergencies system (SAMU) in the Balearic Islands (Spain), 2009-2012

OBJETIVO: Describir las características epidemiológicas de las paradas cardiorrespiratorias extra hospitalarias (PCEH) y determinar los factores asociados a la recuperación de la circulación espontánea (RCE). Diseño: Estudio observacional de cohorte de PCEH registradas de forma continua en la base de datos del SAMU 061 (2009-2012). Ámbito: Islas de Mallorca, Ibiza, Menorca y Formentera. PACIENTES: PCEH ≥ de 18 años. Variables principales de interés: sexo, edad, sospecha etiológica, lugar, testigo, si fue presenciada, soporte vital básico (SVB), ritmo desfibrilable, intervalos de tiempos, desfibrilador semiautomático (DEA), duración de parada cardiaca (PC) y RCE. Las variables independientes fueron definidas según el estilo Utstein y la variable dependiente fue la RCE. RESULTADOS: Se atendió a 1.170 PC (28/100.000 habitantes/año). Se incluyeron 1.130 casos. La edad media fue de 61,4 años. El 72,3% fueron de etiología cardiaca y el 84,7% fueron presenciadas. En 840 (74,3%) se practicó SVB y en 400 (47,6%) se realizó previamente a la llegada del SAMU (45 por familiares). En 330 paradas (29,2%) se utilizó el DEA (96 indicó desfibrilación). Los intervalos alerta-SVB y alerta-SVA fueron de 8,4 y 15,8 min respectivamente. Se monitorizó ritmo desfibrilable en 257 PC (22,7%). La RCE se consiguió en 261 casos (23,1%). Los factores asociados a RCE fueron la edad, el ritmo desfibrilable, SVB previo a la llegada del SAMU y duración de PC ≤ 30 min. CONCLUSIONES: La incidencia de PCEH es baja. El SVB realizado por la familia fue poco frecuente. La edad, ritmo desfibrilable y SVB previo al SAMU se asocian a RCE

OBJECTIVE: To describe the epidemiology of out-of-hospital cardiorespiratory arrest (OHCA) and identify factors associated with recovery of spontaneous circulation (ROSC). Observational study of OHCA registered on a continuous basis in the Emergency Medical Services (EMS) database during 2009-2012. SETTING: The islands of Mallorca, Ibiza, Menorca and Formentera (Balearic Islands, Spain). PATIENTS: OHCA in patients ≥ 18 years of age. The main variables were: Patient sex, age, probable cause, place of arrest, bystander, witnessed, basic life support (BLS), shockable rhythm, intervention time, semi-automatic defibrillator (AED), duration of cardiopulmonary arrest (CA), and ROSC. Independent variables were defined according to the Utstein protocol, and the dependent variable was defined as ROSC. RESULTS: The EMS treated 1170 OHCAs (28/100,000 persons-year). We included 1130 CA. The mean age was 61.4 years (73.4% males). Most CA (72.3%) were of cardiac etiology, and 84.7% were witnessed. A total of 840 (74.3%) received BLS and 400 (47.6%) did so before arrival of the EMS (45 by bystander relatives). AED was available in 330 cases CA (29.2%) (96 with shockable rhythm). The interval between emergency call and BLS and between emergency call and advanced life support was 8.4 and 15.8min, respectively. Shockable rhythm was monitored in 257 CAs (22.7%). ROSC occurred in 261 (23.1%). Factors associated with ROSC were age, shockable rhythm, BLS before EMS arrival, and CA duration less than 30min.ConclusionThe incidence rate of the OHCA is low. The proportion of patients receiving BLS from relatives was low. Age, shockable rhythm and BSL before EMS arrival were associated with ROSC

[Epidemiological characteristics of out-of-hospital cardiorespiratory arrest recorded by the 061 emergencies system (SAMU) in the Balearic Islands (Spain), 2009-2012]. / Características epidemiológicas de las paradas cardiorrespiratorias extrahospitalarias registradas por el sistema de emergencias 061 (SAMU) de la Comunidad Autónoma de las Islas Baleares (2009-2012).

OBJECTIVE: To describe the epidemiology of out-of-hospital cardiorespiratory arrest (OHCA) and identify factors associated with recovery of spontaneous circulation (ROSC). DESIGN: Observational study of OHCA registered on a continuous basis in the Emergency Medical Services (EMS) database during 2009-2012. SETTING: The islands of Mallorca, Ibiza, Menorca and Formentera (Balearic Islands, Spain). PATIENTS: OHCA in patients ≥ 18 years of age. The main variables were: Patient sex, age, probable cause, place of arrest, bystander, witnessed, basic life support (BLS), shockable rhythm, intervention time, semi-automatic defibrillator (AED), duration of cardiopulmonary arrest (CA), and ROSC. Independent variables were defined according to the Utstein protocol, and the dependent variable was defined as ROSC. RESULTS: The EMS treated 1170 OHCAs (28/100,000 persons-year). We included 1130 CA. The mean age was 61.4 years (73.4% males). Most CA (72.3%) were of cardiac etiology, and 84.7% were witnessed. A total of 840 (74.3%) received BLS and 400 (47.6%) did so before arrival of the EMS (45 by bystander relatives). AED was available in 330 cases CA (29.2%) (96 with shockable rhythm). The interval between emergency call and BLS and between emergency call and advanced life support was 8.4 and 15.8min, respectively. Shockable rhythm was monitored in 257 CAs (22.7%). ROSC occurred in 261 (23.1%). Factors associated with ROSC were age, shockable rhythm, BLS before EMS arrival, and CA duration less than 30min. CONCLUSION: The incidence rate of the OHCA is low. The proportion of patients receiving BLS from relatives was low. Age, shockable rhythm and BSL before EMS arrival were associated with ROSC.