Kimman G P, Ivens E M, Hartman J A, Hart H N, Simoons M L
Academisch Ziekenhuis Rotterdam-Dijkzigt, Thoraxcentrum, afd. Cardiologie, Rotterdam.
Ned Tijdschr Geneeskd. 1991 Sep 7;135(36):1635-9.
Between 1983 and 1989, 962 patients in Rotterdam were resuscitated outside hospital, of whom 240 (25%) could be discharged alive. A follow-up study was performed to determine prognosis in these patients. Data were collected through the Municipal Health Service, Population Registries, the hospitals where the patients were admitted, and the general practitioners. Of these 240 survivors of out-of-hospital resuscitation 80% survived after 1 year and 61% after 5 years. During the first year, 9% suffered from myocardial (re)infarction and 13% underwent coronary bypass surgery or angioplasty. Within the first three years after resuscitation 60% of the patients were readmitted to a hospital. Permanent or temporary neurological deficits were observed in 30 patients (14%). Patients with a primary arrhythmia without myocardial infarction had a poorer prognosis than patients with cardiac arrest in the context of an infarct. Survival was better in patients in whom resuscitation was initiated by physicians or ambulance-nurses, than in patients resuscitated by lay-people. Multivariate analysis revealed that this difference was caused by a larger proportion of patients with a primary arrhythmia in the latter group. Since long-term prognosis after out-of-hospital resuscitation is satisfactory, programmes for resuscitation courses should be stimulated. Such courses should be aimed predominantly at relatives of patients with known heart disease, police officers and children.
1983年至1989年间，鹿特丹有962名患者在院外接受了心肺复苏，其中240人（25%）存活出院。开展了一项随访研究以确定这些患者的预后情况。数据通过市卫生服务机构、人口登记处、患者所入住的医院以及全科医生收集。在这240名院外心肺复苏的幸存者中，80%在1年后存活，61%在5年后存活。在第一年，9%的患者发生心肌（再）梗死，13%的患者接受了冠状动脉搭桥手术或血管成形术。心肺复苏后的头三年内，60%的患者再次入院。30名患者（14%）出现了永久性或暂时性神经功能缺损。原发性心律失常但无心肌梗死的患者比梗死情况下心脏骤停的患者预后更差。由医生或救护护士启动心肺复苏的患者比由非专业人员复苏的患者存活率更高。多变量分析显示，这种差异是由后一组中原发性心律失常患者比例较高所致。由于院外心肺复苏后的长期预后令人满意，应推动开展心肺复苏课程项目。此类课程应主要针对已知心脏病患者的亲属、警察和儿童。
