Traduction sommaire pour les anglophobe - - -
Model math�matique d'am�lioration de la survie d'ACR pr�hosp
Selon le pourcentage de RCR effectu� par les t�moins
RESULTAS:
Dans la provinde de l'Ontario de 1995 � 2000,
Sur 7,707 Arr�ts Cardio Respiratoire consecutifs :
Moyenne d'�ge 68.9, 67% male, 37% VF/VT.
(RCR par t�moins % , survie - sortie de l'h�pital) :
49% ACR avec t�moins (23%, 6.8%),
51% ACR Sans t�moins( 11%, 1.3%).
Selon des taux vari� de RCR:
( Estimation de la survie, nombre additionel de vies sauv�es)
20%(4.1%,2),
25%(4.6%,9),
30%(5.1%,17),
35%(5.6%,24),
40%(6.1%,32),
45%(6.5%,39),
50%(7.0%,47),
55%(7.5%,54),
60%(8.0%,62).
Charles
Tir� de :
http://www.ohri.ca/programs/clinical_epidemiology/opals/abstracts/03VaillancourtMathModel.pdf
Vaillancourt C, Stiell IG, Wells GA.
Mathematical Model Predicting the Potential Impact of Various
Community Bystander CPR Rates on Overall Survival From Cardiac
Arrest.
Acad Emerg Med 2003;10:503-b-504-b
OBJECTIVES: Survival from cardiac arrest remains low. Bystander CPR
is a crucial yet weak link of the chain of survival for cardiac
arrest. We sought to determine the potential impact of various
community bystander CPR rates on overall survival from cardiac
arrest.
METHODS: We used descriptive analysis and mathematical modeling of
data prospectively collected within the Ontario Prehospital Advanced
Life Support Study. This study has the largest population-based
cohort of adult out-of-hospital cardiac arrests in 20 communities
with BLS-D and ALS paramedics. We used the following assumptions from
the literature for our mathematical model:
1) bystander CPR is well-performed in 50% of cases;
2) the odds of survival with well-performed CPR compared to
technically incorrect CPR is 3.4;
3) increasing CPR teaching in the community will increase bystander
CPR rates; and
4) improved bystander CPR rates will be in the well-performed CPR
group.
We determined baseline bystander CPR and survival rates for
witnessed and un-witnessed cardiac arrest cases. Victims receiving
bystander CPR were divided in two equal groups and assigned a 3.4
differential survival rate. We varied bystander CPR rate between 20%
and 60%.
RESULTS: From 1995 to 2000, there were 7,707 consecutive cardiac
arrest cases: mean age 68.9, 67% male, 37% VF/VT. Bystander CPR and
survival to discharge were: 49% witnessed (23%,6.8%), and 51%
unwitnessed(11%,1.3%). Estimated overall survival and additional
number of lives saved with various bystander CPR rates are:
20%(4.1%,2), 25%(4.6%,9), 30%(5.1%,17), 35%(5.6%,24), 40%(6.1%,32),
45%(6.5%,39), 50%(7.0%,47), 55%(7.5%,54), 60%(8.0%,62).
CONCLUSION: We used the largest known multicenter cardiac arrest
database to model the potential impact of various bystander CPR
rates. Community interventions designed to improve bystander CPR
rates could have a significant impact on survival from cardiac
arrest. These results may also be used for sample size calculation in
cardiac arrest research.
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