Meta-analysis of the success rate of heartbeat recovery in patients with prehospital cardiac arrest in the past 40 years in China

Xiang-Min Gu; Shi-Bin Yao; Zhong-Jie He; Yong-Gang Wang; Zhi-Hui Li

摘要

Background:Systematic evaluation of the successful heartbeat recovery rate(HRR)in patients during the platinum ten minutes after cardiac arrest.Methods:The databases of CNKI(January 1979–March 2019),Chongqing VIP(January 1989–March 2019),Wanfang(January 1990–March 2019)and Web of Science(January 1900-May 2020)were searched.To collect the clinical data of patients with cardiac arrest before hospitalization and analyze the cardiopulmonary resuscitation(CPR)at different times.Literature selection and data extraction were carried out by two researchers independently,and the meta package of R software(version 3.61)was used for analysis.Results:A total of 116 papers met the inclusion criteria,including 37,181 patients.Of these patients,3367 had their heartbeats successfully restored.The results showed a high degree of heterogeneity(χ2=6999.21,P<0.01,I2=97.6%).The meta-analysis was conducted using a random-effects model.The combined effect size was 0.199(0.157–0.250).(1)According to the five CPR groups(International Cardiopulmonary Resuscitation Guide 2000,2005,2010,2015 and other versions),the HRR of other versions[0.264(0.176–0.375)]was higher than the International Cardiopulmonary Resuscitation 2005 edition[0.121(0.092–0.158)].(2)The rescue time was divided into the 0 to≤5 min group,the 5 to≤10 min group,the 10 to≤15 min group,and the>15 min group.The HRR were 0.417(0.341–0.496),0.143(0.104–0.193),0.049(0.034–0.069),and 0.022(0.009–0.051),respectively.The HRR was higher in the 0 to≤5 min group than in the 5 to≤10 min group,the 10 to≤15 min group and the>15 min group.There was no difference between the 10 to≤15 min group and the>15 min group.(3)When the groups were stratified with the cutoff of 10 min,the≤10 min group HRR[0.250(0.202–0.306)]was higher than the>10 min group rate[0.041(0.029–0.057)].(4)The HRR of the telephone guidance group was[0.273(0.227–0.325)]lower than that of the 0 to≤5 min group[0.429(0.347–0.516)]but higher than that of the 5 to≤10 min group,the 10 to≤15 min group,and the>15 min group.(5)The HRR of the witness group[0.325(0.216–0.458)]was not different from that of the 0 to≤5 min group,but it was higher than those of the 5 to≤10 min group,the 10 to≤15 min group and the>15 min group.(6)There was no significant difference HRR between the witnessed group,the telephone guidance group and the≤10 min group.Conclusions:(1)The HRR is time-sensitive,and early rescue can improve it.(2)CPR performed within the platinum ten minutes must be executed by the public,and other forces are auxiliary.(3)The concept of peri-cardiac arrest period(PCAP)should be established and improved to guide CPR.

机译：背景：在心脏骤停后持续的患者成功心跳回收率（HRR）的系统评价。方法：CNKI（2019年1月至3月至3月），重庆VIP（2019年1月），万功率（2019年1月），万方（2019年1月） 2019年1月 - 2019年3月）和科学网（2010年1月 - 5月2020年）被搜查。在住院前收集心脏骤停的患者的临床资料，并在不同时间分析心肺复苏（CPR）.Literature选择和数据提取由两个研究人员独立执行，并且R软件的元包（版本3.61）用于分析。结果：总共116篇论文符合纳入标准，其中包括37,181名患者，这些患者，3367患者已成功恢复。结果显示出高度的异质性（χ2= 6999.21，P <0.01，I2 = 97.6％）。使用随机效应模型进行了META分析。合并效果尺寸为0.199（0.157-0.250）。（1 ）根据五个CPR组（国际心肺复苏指南2000,2005,2010,2015等版本），其他型号的HRR [0.264（0.176-0.375）]高于国际心肺复苏2005版[0.121（0.092-0.158）]。（2）救援时间分为0〜≤5分钟，5至≤10min组，10至≤15分钟，和> 15分钟的组.HRR为0.417（0.341-0.496）， 0.143（0.104-0.193），0.049（0.034-0.069）和0.022（0.009-0.051）.HRR在0〜≤5min组中高于5〜≤10min组，10°≤ 15分钟和> 15 min组。10至≤15min组和> 15 min组之间没有差异。（3）当该组用10分钟的截止分层时，≤10min组hrr [0.250（0.202-0.306）]高于> 10 min组速率[0.041（0.029-0.057）]。（4）电话指导组的HRR是[0.273（0.227-0.325）]低于那个0至≤5min组[0.429（0.347-0.516）]但高于5到≤10min组，1 0〜≤15min组，> 15分钟的群体。（5）证人组的HRR [0.325（0.216-0.458）]与0〜≤5min组的HRR不同，但其高于5至≤10min组的那些，10至≤15min组和> 15分钟的组。（6）目击组，电话指导组和≤10分钟之间没有显着差异.Conclusions ：（1）人力资源中心是时敏，早期救援可以改善它。（2）在铂金内进行的CPR必须由公众执行，其他力量是辅助的。（3）Peri-Cardiac的概念应建立并改进逮捕期（PCAP）以指导CPR。

Meta-analysis of the success rate of heartbeat recovery in patients with prehospital cardiac arrest in the past 40 years in China

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