THỰC TRẠNG CẤP CỨU TRƯỚC VIỆN TRÊN BỆNH NHÂN NGỪNG TUẦN HOÀN NGOẠI VIỆN TẠI VIỆT NAM: KHOẢNG CÁCH VỚI TIÊU CHUẨN QUỐC TẾ VÀ HƯỚNG CẢI THIỆN

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death and disability. The "Chain of Survival," consisting of six key links proposed by the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR), aims to reduce mortality and improve neurological recovery. In Vietnam, the implementation of the first two links in this chain remains limited and insufficiently studied. Therefore, we conducted this study to assess the current status of the first two links when approaching OHCA patients, with the goal of proposing community-level improvements. Objectives: To evaluate the current status of pre-hospital emergency care in patients with out-of-hospital cardiac arrest in Vietnam. Patients and methods: A retrospective study of OHCA patients admitted to Cho Ray Hospital from January 1, 2019, to June 15, 2024. Results: During the retrospective period, we identified 453 OHCA cases, of which 86 patients met the inclusion criteria. The mean age was 49.1 ± 17.2 years, with the majority aged ≥45 years (59%). Males predominated (79.1%), with a male-to-female ratio of 3.8:1. The recorded mortality rate was 55.8%, and poor in-hospital outcomes occurred in 74.4% of cases. OHCA events primarily occurred at home (56.9%), followed by on streets or highways (19.8%). Although most cases were witnessed (84.9%), only 15.1% received bystander cardiopulmonary resuscitation (CPR), mainly chest compressions alone (12.8%), while CPR with ventilation was rare (2.3%). Survivors tended to receive medical intervention earlier, particularly within 40 minutes (73.6% vs. 45.1%), although this difference was not statistically significant. Conclusions: OHCA in this study was associated with a high mortality rate (55.8%) and a high rate of poor in-hospital outcomes (74.4%). While most OHCA cases were witnessed (84.9%), the bystander CPR rate was low (15.1%).