A meta-analysis of the success rates of heartbeat restoration within the platinum 10min among outpatients suffering from sudden cardiac arrest in China

Xiang-Min; Gu; Zhi-Hui; Li; Zhong-jie; He; Zhe-Wei; Zhao; Shuang-Qing; Liu

摘要

Background:The optimal time to save a person who has had a sudden cardiac arrest is within the first few minutes of the incident.Early compression and early defibrillation should be performed at this time.Timeliness is the key to successful CPR; as such,Prof.He proposed the "platinum 10 min" system to study early CPR issues.This paper systematically evaluates the success rates of heartbeat restoration within the "platinum 10min" among patients suffering from sudden cardiac arrest.Methods:The clinical data of outpatients suffering from a cardiac arrest were retrieved from the China Knowledge Network(January 1975-January 2015),the Chongqing VIP database(January 1989-January 2015),and the Wanfang database(January 1990-January 2015).The success of the cardiopulmonary resuscitation(CPR) performed at different times after the patients had cardiac arrests was analyzed.Two researchers screened the literature and extracted the data independently.A meta-analysis was conducted using Stata 12.0.A total of 57 papers met the inclusion criteria,including 29,269 patients.Of these patients,1,776 had their heartbeats successfully restored.The results showed high heterogeneity(χ~2=3428.85,P<0.01,I2=98.4%).The meta-analysis was conducted using a random-effects model.The combined effect size was 0.171(0.144-0.199).Results:1) The success rate of heartbeat restoration did not differ among the four emergency treatment methods that patients received:the methods described in the 2000 Guidelines for CPR and Emergency Cardiovascular Care,that described in the 2005 version,2010 version,and another CPR method.2) The patients were divided into five groups based on the time when CPR was performed:the ?1min group,the 1-5min group,the 5-10 min group,the 10-15 min group and the >15min group.The CPR success rates of these five groups were 0.247(0.15-0.344),0.353(0.250-0.456),0.136(0.109-0.163),0.058(0.041-0.075),and 0.011(0.004-0.019),respectively.The CPR success rates did not differ between the patients in the ?1min group and the 1-5min group.This success rate was higher for the patients in the 1-5min group than those in the 10-15 min group,those in the 10-15 min group,and those in the >15min group.The CPR success rate was higher for the patients in the 5-10 min group than those in the 10-15 min group and those in the >15min group.The CPR success rate was higher for the patients in the 10-15 min group than those in the >15min group.In addition,the patients were divided into two groups based on whether CPR was performed within the first 10 min after the cardiac arrest occurred:the ?10min group and the >10min group.The CPR success rate was higher for the patients in the ?10min group [0.189(0.161-0.218)] than those in the >10min group [0.044(0.032-0.056)].3) Differences were not found between the CPR success rates among the patients in the telephone guidance group [0.167(0.016-0.351)] and those in the ?1min,1-5min,5-10 min,10-15 min,and >15min groups.4) The CPR success rates did not differ among in the patients in the witness + public group [0.329(0.221-0.436)],those in the ?1min group,and those in the 1-5min group.However,this success rate was higher in the patients in the witness + public group than those in the 5-10 min,10-15 min,and >15min groups.Conclusion:The success rate of heartbeat restoration did not differ among patients receiving CPR based on different guidelines.The success rate of CPR lies in its timeliness.The participation of the general population is the cornerstone of improving CPR.Providing complete emergency treatment equipment and perfecting comprehensive measures can improve the success rate of CPR among patients within the platinum 10 min.CPR research in China must be improved.

机译：背景：拯救突然心脏骤停的人的最佳时间在发生事件的前几分钟内。此时应进行最早的压缩和早期除颤。致力于成功CPR的关键;因此，我们提出了“铂10分钟”系统研究早期的CPR问题。本文系统地评估患有心脏捕集突发的患者“铂10min”中心跳恢复的成功率。方法：临床资料从中国知识网络（2015年1月1975年1月），重庆VIP数据库（2015年1月）和Wanfang数据库（2015年1月至2015年1月），从中国知识网络（2015年1月）遭受了心脏骤停的门诊病人。心肺成功的成功分析患者心脏骤停后在不同时间进行的复苏（CPR）。研究人员筛选了文献，独立提取了数据。使用STATA 12.0.a进行了第57篇论文的纳入标准，包括29,269这些患者，1,776名患者的心跳成功恢复。结果表现出高异质性（χ〜2 = 3428.85，P <0.01，I2 = 98.4％）。使用A进行META分析随机效果模型。效果大小为0.171（0.144-0.199）。结果：1）心跳恢复的成功率在接受患者的四种应急治疗方法中没有差异：2000年CPR和CPR指南中描述的方法紧急心血管护理，在2005年版本，2010版和另一种CPR方法中描述的.2）患者根据CPR进行的时间分为五个群体：1min组，1-5min组，5 -10 min组，10-15分钟和> 15min组。这五组的CPR成功率为0.247（0.15-0.344），0.353（0.250-0.456），0.136（0.109-0.163），0.058（0.041） -0.075）和0.011（0.004-0.019）。CPR成功率在1-5min组的患者中患者与1-5min组之间没有差异。1-5min组患者的成功率更高比10-15分钟的那些，10-15分钟的那些，以及> 15min组的那些.PAT的CPR成功率更高在5-10分钟的群体中比10-15分钟的群体以及> 15min组的群体。患者在10-15分钟内的患者比> 15min Group中的患者的成功率更高此外，患者分为两组，基于CPR在心脏骤停发生后的前10分钟内进行：10min组和> 10min组。患者的CPR成功率较高，适用于10min组的患者[0.189（0.161-0.218）]比> 10min组中的那些[0.044（0.032-0.056）]。3）电话指导组中患者的CPR成功率之间未发现差异[0.167（0.016-0.351） ]和1min，1-5min，5-10分钟，10-15分钟和> 15min组的那些。目击者+公共组的患者中，CPR成功率在[0.329（0.221 -0.436）]，那些在1min组的那些，以及1-5min组的那些。然而，目击者患者的成功率较高，+公共组比5-10分钟，1 0-15分钟和> 15min组。结论：基于不同指导性的CPR患者的心跳恢复成功率没有不同.CPR的成功率在于及时性。一般人口的参与是基石改善CPR.采用完整的紧急治疗设备，完善的综合措施可以提高铂金内患者中CPR的成功率，10分钟内部必须得到改善。

A meta-analysis of the success rates of heartbeat restoration within the platinum 10min among outpatients suffering from sudden cardiac arrest in China

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