| 53 Povratak spontane cirkulacije kod pacijenata srčanog zastoja kardiološke etiologije u populaciji odraslih u Srbiji ROSC in out-of-hospital cardiac arrest patients by cardiologic etiology in the adult population in Serbia Sažetak Cilj: Utvrđivanje epidemiologije srčanog zastoja kardiološke etiologije kod pacijenata starijih od 18 godina u Srbiji, svrstanih u tri starosne kate- gorije. Metodologija: Analizirani su podaci prikupljeni iz prospektivne studije, observa- cionog trijala Evropskog Resuscitacionog Saveta koji je pod brojem NCT02236819 registrovan u bazi trijala i odobren od zdravstvenih au- toriteta u SAD. Podatke u registar srčanog zastoja EuReCa Srbija su unosili glavni istraživači svake ustanove u jedinstvenu bazu putem on- lajn unosa (www.eureca.rs). U analizu su uključeni svi pacijenti stari- ji od 18 godina kod kojih su sprovedene mere kardiopulmonalne re- suscitacije od strane Službe hitne medicinske pomoći u periodu od 1. januara 2017. godine do 01. avgusta 2017. Pacijenti su podeljeni u tri grupe: prva grupa 18-65 godina, druga grupa 66-80 i treća grupa os- obe preko 80 godina. Za obradu podataka je korišten program Statistika. Rezultati: U periodu od 1.10.2014. godine do 1.08.2017. godine, u Srbiji je regi- strovano 3153 osoba sa srčanim zastojem. Mere kardiopulmonalne resuscitacije su započete kod 1385/3153 (44%). Tokom posmatranog perioda, registrovano je 593/1385 (43%) pacijenta ≥18 godina koji su doživeli vanbolnički srčani zastoj i kod kojih su primenjene mere kardio- pulmonalne resuscitacije kardiološkog etiološkog uzroka, a koji nije sve- dočen od strane službe hitne medicinske pomoći. U grupi 18-65 godina srčani zastoj imalo 271/593 (46%), u grupi između 66-80 godina VBSZ je imalo 239/593 (40%) i osobe preko 80 godina, 83/593 (14%). U gru- pi od 18 do 65 godina, svedok je bio prisutan 243/271 puta (89.6%), u grupi 66-80 godina svedok je prisustvovao 222/239 (92%) slučaja, dok je preko 80 godina osvedočeno 76/83 (91.5%). Incicijalni ritam VF/VT bez pulsa je u kategoriji 18-65 bio 94/271 (34.6%), u grupi 66-80 šo- kabilni inicijalni ritam je 66/239 (27.6%), dok je preko 80 godina 13/83 (15.6%). Povratak spontane cirkulacije (ROSC) je postignut kod osoba 18-65 godina 68/271 (25%), u grupi 66-80 kod 57/239 (23.8%), a pre- ko 80 god. 13/83 (15.6%). Do otpusta je preživelo 10/271 (3.6%) staro- sti 18-65 godina, od 66-80 godina 12/239 (5.0%) a preko 80 god. 2/83 (2.4%). Više od 30 dana od otpusta je preživelo 10/271 (3.7%) u kate- goriji 18-65 godina, starosti 66-80 godina 11/239 (4.6%), dok je preko 80 godina preživelo 2/83 (2.4%). Zaključak: Postoji značajna razlika u preživljavanju vanbolničkog srčanog zasto- ja između pojedinih, ovim istraživanjem definisanih starosnih struk- tura stanovništva. Podaci o značajno većem preživljavanju (4-6 puta) najstarijih kategorija stanovništva, u odnosu na one od 18-65 godi- na, zahtevaju dalja istraživanja i pokašaje boljeg razumevanja razlo- ga za navedeno. Mihaela Budimski 1 , Zlatko Fišer 2, Violetta Raffay³ Abstract Aim: Determination of epidemiology of cardiac arrest by cardiologic etiology in patients older than 18 years in Serbia, classified into three age groups Methodology: The analyzed data’s are collected from the prospective study, an obser- vational trial of the European Resuscitation Council under the number NCT02236819, registered in the trial database and approved by the he- alth authorities in the United States. Datas’ in the EuReCa Serbia Car- diac Arrest Register has been entered by the lead investigators of ea- ch institution into a unique database via online entry (www.eureca.rs). The analysis included all patients over 18 years of age who underwent cardiopulmonary resuscitation by the Emergency Medical Service in the period from 1 January 2017 to 1 August 2017. Patients are divided into three groups: first group 18-65 years; the second group 66-80 and the third group is over 80 years. Statistics and Microsoft Excel 2016 program was used for data processing. Results: In the period of 1.10.2014 - 01.08.2017, 3153 patients with cardiac arrest were registered in Serbia. Cardiopulmonary resuscitation was star- ted in 1385/3153 (44%). During the observed period, 593/1385 (43%) of patients ≥18 years who had out-of-hospital cardiac arrest with cardiolo- gic etiology where cardiopulmonary resuscitation has been applied, and which was not testified by the emergency medical service. In the 18-65 age group, the cardiac arrest was present in 271/593 (46%), in the group between 66-80 years OHCA had 239/593 (40%) and in the group over 80, 83/593 (14%). In the 18-65 age group, witnesses were present 243/271 times (89.6%), in the 66-80 age group in 222/239 (92%) cases, while over 80 years ago, 76/83 (91.5 %). The initial rhythm VF / pVT in the 18-65 group was 94/271 (34.6%), in the group of 66-80, the initial shockable rhythm was 66/239 (27.6%), while over 80 years 13/83 (15.6% ). Return of spontaneous circulation (ROSC) was achieved in 68/271 (25%) in 18- 65 age group, in the group of 66-80 in 57/239 (23.8%), and over 80 ye- ars. 13/83 (15.6%). Hospital discharge survival was 10/271 (3.6%) in the group of 18-65 years, among 66-80 years group was 12/239 (5.0%) and in the group over 80 years was 2/83 (2.4%). The rate of 30 days sur- vival after hospital discharge was 10/271 (3.7%) in the 18-65 age gro- up, 11/239 (4.6%) in group of 66-80 years and 2/83 (2.4%) in the gro- up over 80 years. Conclusion: There is a significant difference in the survival of outpatient cardiac arrest between individuals, by exploring the age structure of the population. Data on significantly higher survival (4-6 times) of the oldest populati- on categories, compared to those aged 18-65, require further investi- gations which will lead to deeper insights of the underlying reasons re- lated to this topic. ISSN 2466-2623 USTANOVA ¹ Služba Hitne medicinske pomoći Dom zdravlja Subotica ² Zavod za Hitnu medicinsku pomoć Novi Sad ³ Resuscitacioni Savet Srbije AUTOR ZA KORESPODENCIJU: Mihaela Budimski e-mail: dzsupiar@gmail.com KLJUČNE REČI: EuReCa Srbija, vanbolnički srčani zastoj, kardiopulmonalna resuscitacija, starosna dob, etiologija kardiološka, hitna medicinska pomoć EuReCa Serbia, out-of-hospital cardiac arrest, cardiopulmonary resuscitation, age groups, emergency medical services DATUM PRIJEMA RADA 3. oktobar 2017. DATUM PRIHVATANJA RADA 17. oktobar 2017. DATUM OBJAVLJIVANJA 5. decembar 2017. UDC 616.12-008.315-083.98:616-005(497.11)“2017“ DOI:10.5937/JRB1708053B Journal Resuscitatio Balcanica 2017; 8: 53-57 Originalni rad