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溺水所致院外心脏骤停患者的特征及预后

Characteristics and outcome among patients suffering out-of-hospital cardiac arrest due to drowning.

作者信息

Claesson Andreas, Svensson Leif, Silfverstolpe Johan, Herlitz Johan

机构信息

Kungälv Ambulance Service, Kungälv, Sweden.

出版信息

Resuscitation. 2008 Mar;76(3):381-7. doi: 10.1016/j.resuscitation.2007.09.003. Epub 2007 Nov 7.

Abstract

AIM

To describe the characteristics and outcome among patients with out-of-hospital cardiac arrest (OHCA) caused by drowning as compared with OHCA caused by a cardiac etiology (outside home).

PATIENTS AND METHODS

All the patients included in the Swedish OHCA Registry between 1990 and 2005 which were not crew witnessed, in whom cardio-pulmonary resuscitation (CPR) was attempted, were evaluated for inclusion. Those caused by drowning were compared with those with a cardiac etiology (outside home).

RESULTS

Patients with OHCA due to drowning (n=255) differed from patients with OHCA with a cardiac etiology (n=7494) as they were younger, less frequently suffered a witnessed OHCA, more frequently received bystander CPR and less frequently were found in a shockable rhythm. Patients with OHCA due to drowning had a prolonged ambulance response time as compared with patients with OHCA with a cardiac etiology. Patients with OHCA due to drowning had a survival rate to 1 month of 11.5% as compared with 8.8% among patients with OHCA due to a cardiac etiology (NS). Among patients with OHCA due to drowning, only one independent predictor of survival was defined, i.e. time from calling for an ambulance until the arrival of the rescue team, with a much higher survival among patients with a shorter ambulance response time.

CONCLUSION

Among patients with OHCA 0.9% were caused by drowning. They had a similar survival rate to 1 month as compared with OHCA outside home with a cardiac etiology. The factor associated with survival was the ambulance response time; a higher survival with a shorter response time.

摘要

目的

描述溺水导致的院外心脏骤停(OHCA)患者与心脏病因(家庭外)导致的OHCA患者的特征及预后。

患者与方法

对1990年至2005年纳入瑞典OHCA登记处的所有患者进行评估,这些患者并非由医护人员目击,且尝试进行了心肺复苏(CPR)。将溺水导致的患者与心脏病因(家庭外)导致的患者进行比较。

结果

溺水导致OHCA的患者(n = 255)与心脏病因导致OHCA的患者(n = 7494)不同,前者更年轻,目击OHCA的情况较少,接受旁观者CPR的频率更高,出现可电击心律的频率更低。与心脏病因导致OHCA的患者相比,溺水导致OHCA的患者救护车响应时间更长。溺水导致OHCA的患者1个月生存率为11.5%,而心脏病因导致OHCA的患者为8.8%(无显著差异)。在溺水导致OHCA的患者中,仅确定了一个生存的独立预测因素,即从呼叫救护车到救援团队到达的时间,救护车响应时间较短的患者生存率更高。

结论

OHCA患者中有0.9%是由溺水导致的。与家庭外心脏病因导致的OHCA相比,他们1个月的生存率相似。与生存相关的因素是救护车响应时间;响应时间越短生存率越高。

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