Zoch T W, Desbiens N A, DeStefano F, Stueland D T, Layde P M
Theda Clark Regional Medical Center, 130 Second St, PO Box 2021, Neenah, WI 54957-2021, USA.
Arch Intern Med. 2000 Jul 10;160(13):1969-73. doi: 10.1001/archinte.160.13.1969.
The objective was to evaluate the effect of patient characteristics and other factors on cardiopulmonary resuscitation (CPR) survival, hospital discharge survival and function, and long-term survival.
All patients 18 years and older experiencing in-hospital CPR from December 1983 through November 1991 at Marshfield Medical Center (Marshfield Clinic and adjoining St Joseph's Hospital), Marshfield, Wis, were selected. We performed a retrospective medical record review and augmented these data with updated vital status information.
Cardiopulmonary resuscitation survival, hospital discharge survival and function, and long-term survival.
Of 948 admissions during which CPR was performed, 61.2% of patients survived the arrest and 32.2% survived to hospital discharge. Mechanism of arrest was the most important variable associated with hospital discharge. Patients with pulseless electrical activity had the worst chance of hospital discharge, followed by those with asystole and bradycardia. Follow-up information was available for 298 patients who survived to discharge. One year after hospital discharge, 24.5% of patients, regardless of age, had died. Survival was 18.5% at 7 years in those 70 years or older, compared with 45.4% in those aged 18 to 69 years. Heart rhythm at the time of arrest strongly influenced long-term survival. Bradyarrhythmias produced a nearly 2-fold increased mortality risk compared with normal sinus rhythm.
Survival until hospital discharge after CPR at our institution during an 8-year period was higher than previously reported for other institutions. Long-term survival after discharge was equal to or higher than reported estimates from other institutions. Hospital admission practices and selection of patients receiving CPR may account for these findings.
目的是评估患者特征及其他因素对心肺复苏（CPR）存活、出院存活及功能以及长期存活的影响。
选取1983年12月至1991年11月在威斯康星州马什菲尔德市马什菲尔德医疗中心（马什菲尔德诊所及毗邻的圣约瑟夫医院）接受院内心肺复苏的所有18岁及以上患者。我们进行了回顾性病历审查，并用最新的生命状态信息补充了这些数据。
心肺复苏存活、出院存活及功能以及长期存活。
在进行心肺复苏的948例入院患者中，61.2%的患者心跳骤停后存活，32.2%存活至出院。心跳骤停机制是与出院相关的最重要变量。无脉电活动患者出院机会最差，其次是心搏停止和心动过缓患者。对298例存活至出院的患者进行了随访。出院一年后，无论年龄大小，24.5%的患者死亡。70岁及以上患者7年生存率为18.5%，而18至69岁患者为45.4%。心跳骤停时的心律对长期存活有强烈影响。与正常窦性心律相比，缓慢性心律失常导致的死亡风险增加近2倍。
在我们机构8年期间，心肺复苏后存活至出院的比例高于其他机构先前报告的比例。出院后的长期存活等于或高于其他机构报告的估计值。医院入院做法及接受心肺复苏患者的选择可能是这些结果的原因。
