최근 우리나라는 고령인구의 급격한 증가와 서구적인 생활습관의 확대로 심·뇌혈관계질환에 의한 사망률이 급격히 높아지고 있다. 10대 사망 원인 중 특히 급성심정지(sudden cardiac arrest, SCA)와 관련이 높은 순환기계통 질환으로 인한 사망은 2008년 기준 총 54,085명(인구 10만명당 112.3명)으로 10대 사망원인의 21.9%를 차지하고 있다(통계청, 2009). 2001년과 2004년 대규모로 진행된 후향적 조사들에 의하면 미국과 캐나다의 경우 SCA가 가장 흔한 사망원인이며 미국의 경우 매년 약 330,000명이 심장동맥질환으로 인한 SCA로 사망하고, 약 250,000명이 병원 전 환경에서 SCA로 사망하는 것으로 보고되어있다(Zheng, Croft, Giles, & Mensah, 2001; Chugh et al., 2004; Vaillancourt & Stiell, 2004). 유럽에서는 연간 약 300,000명의 병원전 심정지(out-of-hospital cardiac arrest, OHCA)가 발생하며, 생존율은 약 10.7%이었다(Atwood, Eisenberg, Herlitz & Rea, 2005).
"The aim of this study was to investigate the factors related to the survival of victims with SCA (sudden cardiac arrest) from prehospital settings, who were transferred to hospitals by EMS (emergency medical services) squads due to OHCA (out-of-hospital cardiac arrest). Authors analyzed prehospital care report sheets data, which were prepared by EMS personnel regarding cardiac arrest victims in 1,810 cases who were transferred to hospital through 119 EMS squads in A areas from Jan 1, 2008 to Dec 31, 2008. Among 1,810 OHCA victims, the cases that were transferred to hospital with sustained ROSC (return of spontaneous circulation), which were classified into ""survival"", were 33 (1.8%). There was no statistically significant difference in the survival according to victims' gender, age, job and location of cardiac arrests. OHCA caused by presumed diseases, the cases of presumed cardiogenic cardiac arrests showed the highest survival rate (P=0.008). The survival rate was significantly high (P<0.001) in the case of ventricular fibrillation. In the case of defibrillation being performed, the survival rate was significantly higher (P<0.001) than being not done. And the survival rate was significantly affected (OR=1.021, 95% CI=1.004-1.031) by shortening the time gap from the occurrence of OHCA to call. The survival rate was significantly higher (OR=1.094, 95% CI=1.026-1.166) when the duration between cardiac arrest and CPR was shorter. Furthermore, the survival rate was significantly higher (OR=1.117, 95% CI=1.016-1.228) when the duration between OHCA and defibrillation was shorter. The results of multiple logistic regressions analysis on time variable, indicated that the duration between OHCA and defibrillation was significantly influenced upon victims' survival rate (OR=0.819, 95% CI=0.695-0.966). However, the execution of CPR by lay people from the scene did not affect on the victim's survival rate. In conclusion, it was suggested that expansion of PAD (public access defibrillation) program, provision of standardized education program of CPR, and performance of qualified CPR, were needed for the improvement of survival rate of OHCA victim. Key words: Cardiac arrest, Out-of-hospital cardiac arrest, Survival"
\"Ⅰ. 서 론 Ⅱ. 연구 방법 Ⅲ. 연구결과 및 논의 Ⅳ. 결론 참고 문헌\"
