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放射科发生的心肺骤停:患者特征、发生率及结局

Cardiopulmonary arrest occurring in the radiology department: patient characteristics, incidence, and outcomes.

作者信息

Hope William W, von der Embse Kendra, Mostafa Gamal, Redvanly Richard D, Kelley Michael J, Sing Ronald F, Heniford B Todd

机构信息

Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, North Carolina 28401, USA.

出版信息

Am Surg. 2011 Mar;77(3):273-6.

Abstract

Despite efforts for patient stabilization before radiologic procedures, cardiopulmonary arrests still occur. The purpose of our study was to define the incidence, patient characteristics, and outcomes of patients having cardiopulmonary arrest in a radiology department. We retrospectively reviewed patients sustaining cardiopulmonary arrest in the radiology department from 2002 to 2007. Patient characteristics and outcomes were documented. Descriptive statistics were calculated. Over the 6 years of the study, 1,480,578 radiographic procedures were performed, and 27 patients sustained a cardiopulmonary arrest in the radiology department for an incidence rate of 0.002 per cent. The average patient age was 66 years (range, 35 to 88 years); 12 were male (44%). Radiological procedures were diagnostic in 15 cases and therapeutic in 12 cases. The most common locations for arrest were in the CT area (9 patients) and the vascular procedures area (8 patients). The most common preprocedural patient locations were the hospital wards (11 patients [41%]), the emergency department/trauma bay (5 patients [19%]), the intensive care unit (4 patients [15%]), and an outpatient setting (four patients [15%]). Nineteen patients (70%) survived the initial code, 14 patients (52%) survived 24 hours, and 9 patients (33%) survived until discharge. Survival to discharge was significantly impacted by body mass index (P = 0.005) and type of radiologic procedure (P = 0.04) but not by the preprocedure patient location. Cardiopulmonary arrest occurring in the radiology department is a rare but potentially lethal occurrence. Patients undergoing vascular access procedures may be an at-risk group. Further study is needed to evaluate potential risk factors for cardiopulmonary arrest occurring in the radiology department.

摘要

尽管在放射学检查前已努力使患者病情稳定,但心肺骤停仍时有发生。我们研究的目的是确定放射科中心肺骤停患者的发生率、患者特征及转归情况。我们回顾性分析了2002年至2007年在放射科发生心肺骤停的患者。记录患者特征及转归情况,并进行描述性统计分析。在研究的6年期间,共进行了1,480,578次放射学检查,27例患者在放射科发生心肺骤停,发生率为0.002%。患者平均年龄为66岁(范围35至88岁);男性12例(44%)。放射学检查中诊断性检查15例,治疗性检查12例。最常发生骤停的地点是CT区域(9例患者)和血管介入区域(8例患者)。术前患者最常所在的地点是医院病房(11例患者[41%])、急诊科/创伤区(5例患者[19%])、重症监护病房(4例患者[15%])和门诊(4例患者[15%])。19例患者(70%)在初次抢救成功,14例患者(52%)存活24小时,9例患者(33%)存活至出院。出院存活率受体重指数(P = 0.005)和放射学检查类型(P = 0.04)的显著影响,但不受术前患者所在地点的影响。放射科发生的心肺骤停虽罕见但可能致命。接受血管介入操作的患者可能是高危人群。需要进一步研究以评估放射科发生心肺骤停的潜在危险因素。

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