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院外心脏骤停后的3年生存率及生活质量

[3-year-survival and quality of life after out-of-hospital heart arrest].

作者信息

Polo V, Ardeleani G, Pistone G, Baltrocchi M, Mongiat R, Porro A, Macchi C

机构信息

Divisione di Medicina Interna, Ospedale di Sesto S. Giovanni.

出版信息

Ann Ital Med Int. 2000 Oct-Dec;15(4):255-62.

Abstract

Although the long- and short-term aspects of the outcome of advanced cardiopulmonary resuscitation on patients have been studied to evaluate the percentage of survival up to the moment of discharge from hospital, little information has been published concerning the patients' long-term quality of life. In order to verify the efficiency of our group we retrospectively evaluated 468 subjects admitted to the Emergency Room of Rho Hospital (Milan, Italy) for out-of-hospital cardiac arrest that had occurred over a 90-month period. We studied the correlations between some variables: epidemiological (sex and age), objective (time required for advanced cardiopulmonary resuscitation and type of arrhythmias in the Emergency Room) and instrumental (left ventricular ejection fraction) and post-discharge survival. We also considered the state of health of the survivors by means of a questionnaire on their quality of life. Our data show that: a) 10.25% of the patients were discharged alive; b) younger men (< 65 years old) admitted with a ventricular fibrillation (p = 0.01) and those who had undergone advanced cardiopulmonary resuscitation for less than 25 min (p = 0.001) had a better survival rate at 3 years from discharge; c) 64% of the survivors have a satisfactory quality of life; d) younger age (p = 0.01) and cardiac left ventricular ejection fraction (> 40%) (p = 0.05) are positive predictors for future work capacity. In conclusion, we believe that the critical moment following advanced cardiopulmonary resuscitation is hospitalization because after discharge survival percentage abruptly increased from 10.25 to 65%.

摘要

尽管已对晚期心肺复苏对患者结局的长期和短期方面进行了研究,以评估直至出院时的生存率,但关于患者长期生活质量的信息却鲜有发表。为了验证我们团队的治疗效果,我们回顾性评估了在90个月期间因院外心脏骤停而入住罗医院(意大利米兰)急诊室的468名患者。我们研究了一些变量之间的相关性:流行病学变量(性别和年龄)、客观变量(晚期心肺复苏所需时间和急诊室心律失常类型)和器械变量(左心室射血分数)与出院后生存率之间的相关性。我们还通过一份关于生活质量的问卷来考量幸存者的健康状况。我们的数据显示:a)10.25%的患者存活出院;b)因室颤入院的较年轻男性(<65岁)(p = 0.01)以及接受晚期心肺复苏少于25分钟的患者(p = 0.001)在出院3年后的生存率更高;c)64%的幸存者生活质量令人满意;d)较年轻的年龄(p = 0.01)和心脏左心室射血分数(>40%)(p = 0.05)是未来工作能力的积极预测因素。总之,我们认为晚期心肺复苏后的关键阶段是住院治疗,因为出院后生存率从10.25%急剧上升至65%。

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