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尝试进行心肺复苏的院外心脏骤停年轻成年人的特征及预后

Characteristics and outcome amongst young adults suffering from out-of-hospital cardiac arrest in whom cardiopulmonary resuscitation is attempted.

作者信息

Herlitz J, Svensson L, Silfverstolpe J, Angquist K-A, Wisten A, Engdahl J, Holmberg S

机构信息

Institution of Internal Medicine, Department of Metabolism and Cardiovascular Research, Sahlgrenska University Hospital, Göteborg, Sweden.

出版信息

J Intern Med. 2006 Nov;260(5):435-41. doi: 10.1111/j.1365-2796.2006.01705.x.

DOI:10.1111/j.1365-2796.2006.01705.x
PMID:17040249
Abstract

OBJECTIVES

Amongst patients suffering from out-of-hospital cardiac arrest, young adults represent a minority. However, these victims suffer from the catastrophe when they are in a very active phase of life and have a long life expectancy. This survey aims to describe young adults in Sweden who suffer from out-of-hospital cardiac arrest and in whom cardiopulmonary resuscitation (CPR) is attempted in terms of characteristics and outcome.

DESIGN

Prospective and descriptive design.

SUBJECTS AND METHODS

Young adults (18-35 years) who suffered from out-of-hospital cardiac arrest in whom CPR was attempted and who were included in the Swedish Cardiac Arrest Registry between 1990 and 2004.

MAIN OUTCOME MEASURES

Survival to 1 month.

RESULTS

In all, 1105 young adults (3.1% of all the patients in the registry) were included, of which 29% were females, 51% were nonwitnessed and 15% had a cardiac aetiology. Only 17% were found in ventricular fibrillation, 53% received bystander CPR. The overall survival to 1 month was 6.3%. High survival was found amongst patients found in ventricular fibrillation (20.8%) and those with a cardiac aetiology (14.8%). Ventricular fibrillation at the arrival of the rescue team remained an independent predictor of an increased chance of survival (odds ratio: 7.43; 95% confidence interval: 3.44-16.65).

CONCLUSION

Amongst young adults suffering from out-of-hospital cardiac arrest and in whom CPR was attempted, a minority survived to 1 month. Subgroups with a higher survival could be defined (patients found in ventricular fibrillation and patients in whom there was a cardiac aetiology). However, only one independent predictor of an increased chance of survival could be demonstrated, i.e. ventricular fibrillation at the arrival of the rescue team.

摘要

目的

在院外心脏骤停患者中,年轻人占少数。然而,这些受害者在生命非常活跃的阶段遭遇这场灾难,且预期寿命较长。本调查旨在描述瑞典院外心脏骤停且尝试进行心肺复苏(CPR)的年轻人的特征和结局。

设计

前瞻性描述性设计。

研究对象与方法

1990年至2004年间,在瑞典心脏骤停登记处登记的、尝试进行心肺复苏的院外心脏骤停年轻成年人(18 - 35岁)。

主要观察指标

存活至1个月。

结果

共纳入1105名年轻成年人(占登记处所有患者的3.1%),其中29%为女性,51%为非目击骤停,15%有心脏病因。仅17%为心室颤动,53%接受了旁观者心肺复苏。总体存活至1个月的比例为6.3%。心室颤动患者(20.8%)和有心脏病因的患者(14.8%)存活率较高。救援团队到达时为心室颤动仍是存活几率增加的独立预测因素(比值比:7.43;95%置信区间:3.44 - 16.65)。

结论

在尝试进行心肺复苏的院外心脏骤停年轻成年人中,少数人存活至1个月。可确定存活率较高的亚组(心室颤动患者和有心脏病因的患者)。然而,仅能证明一个存活几率增加的独立预测因素,即救援团队到达时为心室颤动。

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