Fredriksson Martin, Aune Solveig, Thorén Ann-Britt, Herlitz Johan
Sahlgrenska University Hospital, Department of Cardiology, SE-413 45 Goteborg, Sweden.
Resuscitation. 2006 Mar;68(3):351-8. doi: 10.1016/j.resuscitation.2005.07.011. Epub 2006 Feb 3.
In-hospital cardiac arrest is one of the most stressful situations in modern medicine. Since 1997, there has been a uniform way of reporting - the Utstein guidelines for in-hospital cardiac arrest reporting.
We have studied all consecutive cardiac arrest in the Sahlgrenska University Hospital (SU) between 1994 and 2001 for who the rescue team was alerted in all 833 patients. The primary endpoint for this study was survival to discharge.
Thirty-seven percent survived to hospital discharge. Among patients who were discharged alive, 86% were alive 1 year later. The survivors have a good cerebral outcome (94% among those who were discharged alive had cerebral performance category (CPC) score 1 or 2). The organization at SU is efficient; 80% of the cardiac arrest had CPR within 1 min. Time from cardiac arrest to first defibrillation is a median of 2 min. Almost two-thirds of the patients were admitted for cardiac related diagnoses.
The current study is the largest single-centre study of in hospital cardiac arrest reported according to the Utstein guidelines. We report a high survival for in-hospital cardiac arrest. We have pointed out that a functional chain of survival, short intervals before the start of CPR and defibrillation are probably contributing factors for this.
院内心脏骤停是现代医学中压力最大的情况之一。自1997年以来,一直有一种统一的报告方式——用于报告院内心脏骤停的乌斯坦指南。
我们研究了1994年至2001年间在萨尔格伦斯卡大学医院(SU)发生的所有连续性心脏骤停事件,共833例患者,均呼叫了抢救团队。本研究的主要终点是出院存活率。
37%的患者存活至出院。在存活出院的患者中,86%在1年后仍然存活。存活者的脑功能预后良好(存活出院的患者中有94%的脑功能分级(CPC)评分为1或2)。SU医院的组织工作高效;80%的心脏骤停患者在1分钟内接受了心肺复苏。从心脏骤停到首次除颤的时间中位数为2分钟。近三分之二的患者因心脏相关诊断入院。
本研究是根据乌斯坦指南报告的最大规模的单中心院内心脏骤停研究。我们报告了较高的院内心脏骤停存活率。我们指出,有效的生存链、心肺复苏和除颤开始前的短间隔时间可能是导致这一结果的因素。