Yap H Y, Li Thomas S T, Tan K S, Cheung Y S, Chui P T, Lam Philip K N, Lam Desmond W l, Tong Y F, Chu M C, Leung P N, Joynt Gavin M
Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Shatin, Hong Kong.
Hong Kong Med J. 2007 Aug;13(4):258-65. Epub 2007 Jun 4.
To examine the demographics, process indicators of adult in-hospital cardiopulmonary arrest resuscitation, and outcomes in a teaching hospital in Hong Kong.
Retrospective study.
A university-affiliated tertiary referral hospital with 997 acute adult beds in Hong Kong.
Those who suffered a cardiopulmonary resuscitation event, as documented in retrieved records of all in-patients during the inclusive period January 2002 to December 2005.
There were 531 resuscitation events; the mean (standard deviation) age of the corresponding patients was 70.7 (15.4) years. Most (83%) occurred in non-monitored areas and most (97%) were cardiopulmonary arrests. The predominant initial rhythm was asystole (52%); only 8% of patients had ventricular tachycardia/fibrillation. All the resuscitations were initiated by on-site first responders. The median times from collapse to arrival of the resuscitation team, to defibrillation, to administration of adrenaline, and to intubation were: 5 (interquartile range, 2-6) minutes, 5 (1-7) minutes, 5 (3-10) minutes, and 9 (5-13) minutes, respectively. The overall hospital survival (discharge) rate was 5%. The survival rate was higher among patients in monitored areas (9 vs 4%, P=0.046), among patients with isolated respiratory arrests (61 vs 3%, P<0.001), primary ventricular tachycardia/fibrillation arrests (13 vs 4%, P<0.001), shorter interval times from collapse to medication (1.5 vs 5 min, P=0.013), and longer interval times to intubation (12 vs 8 min, P=0.013).
Hospital survival after in-hospital cardiopulmonary arrests was poor. Possible strategies to improve survival include shorten time interval to defibrillation, and provision of more monitored beds.
研究香港一家教学医院中成人住院期间心肺复苏的人口统计学特征、过程指标及结果。
回顾性研究。
香港一所大学附属的三级转诊医院，拥有997张急性成人病床。
2002年1月至2005年12月期间所有住院患者检索记录中记录有经历心肺复苏事件的患者。
共发生531次复苏事件；相应患者的平均（标准差）年龄为70.7（15.4）岁。大多数（83%）发生在非监测区域，大多数（97%）为心脏骤停。主要的初始心律为心搏停止（52%）；只有8%的患者出现室性心动过速/心室颤动。所有复苏均由现场急救人员发起。从心脏骤停至复苏团队到达、至除颤、至给予肾上腺素及至插管的中位时间分别为：5（四分位间距，2 - 6）分钟、5（1 - 7）分钟、5（3 - 10）分钟及9（5 - 13）分钟。总体医院生存率（出院率）为5%。监测区域患者的生存率较高（9%对4%，P = 0.046），孤立性呼吸骤停患者（61%对3%，P < 0.001）、原发性室性心动过速/心室颤动性心脏骤停患者（13%对4%，P < 0.001）、从心脏骤停至用药间隔时间较短者（1.5对5分钟，P = 0.013）及至插管间隔时间较长者（12对8分钟，P = 0.013）的生存率较高。
住院期间心脏骤停后的医院生存率较低。提高生存率的可能策略包括缩短除颤时间间隔及提供更多监测床位。
