Mechanical chest compression devices are associated with poor neurological survival in a statewide registry: A propensity score analysis

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• 作者：Scott T. Youngquist^a ; ^b ; ^{scott.youngquist@utah.edu" class="auth_mail" title="E-mail the corresponding author} ; Patrick Ockerse^a ; Sydney Hartsell^c ; Chris Stratford^a ; Peter Taillac^a ; ^d
• 关键词：Cardiac Arrest ; Chest Compressions ; Mechanical Devices
• 刊名：Resuscitation
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：106
• 期：Complete
• 页码：102-107
• 全文大小：570 K

文摘

To compare functional survival (discharge cerebral performance category 1 or 2) among victims of out-of-hospital cardiac arrest (OHCA) who had resuscitations performed using mechanical chest compression (mech-CC) devices vs. those using manual chest compressions (man-CC).

Methods

Observational cohort of 2600 cases of OHCA from a statewide, prospectively-collected cardiac arrest registry (Utah Cardiac Arrest Registry to Enhance Survival). Comparison of functional survival among those receiving mech-CC vs man-CC was performed using a mixed-effects Poisson model with inverse probability weighted propensity scores to control for selection bias.

Results

Overall, mech-CC was utilized in 405/2600 (16%) of the total arrests in Utah during this period. 371/405 (92%) were of the load-distributing band type (AutoPulse^®) and 22/405 (5%) were mechanical piston devices (LUCAS™), while 12/405 (3%) employed other devices. The relative risk (RR) for functional survival comparing mech-CC to man-CC after propensity score adjustment was 0.41 (95% CI 0.24–0.70, p = 0.001).

Conclusions

Mechanical chest compression device use was associated with lower rates of functional survival in this propensity score analysis, controlling for Utstein variables and early return of spontaneous circulation.