Emergency Medical Services Division of Public Health for Seattle and King County, Seattle, WA 98104 , USA.
Resuscitation. 2012 Aug;83(8):1001-5. doi: 10.1016/j.resuscitation.2012.01.029. Epub 2012 Feb 1.
Little is known about long-term prognosis following resuscitation from out-of-hospital cardiac arrest, especially as it relates to the presenting rhythm or arrest aetiology. We investigated long-term survival among those discharged alive following resuscitation according to presenting rhythm and arrest aetiology.
We conducted a cohort investigation of all non-traumatic adult out-of-hospital cardiac arrest patients resuscitated and discharged alive from hospital between January 1, 2001 and December 31, 2009 in a large metropolitan emergency medical service system. Information about demographics, circumstances, presenting arrest rhythm and aetiology was collected using the dispatch, EMS, and hospital records. Long-term vital status was ascertained using state death records and the Social Security Death Index through 31st December 2010. We used Kaplan Meier to evaluate survival.
During the study period, a total of 1001/5958 (17%) persons were resuscitated and discharged alive, of whom 313/1001 (31%) presented with a non-shockable rhythm and 210/1001 (21%) had a non-cardiac aetiology. Overall median survival was 9.8 years with 64% surviving >5 years. Five-year survival was 43% for non-shockable rhythms compared to 73% for shockable rhythms, and 45% for non-cardiac aetiology compared to 69% for cardiac aetiology (p<0.001 respectively).
Cardiac arrest due to non-shockable rhythm or non-cardiac aetiology comprises a substantial proportion of those who survive to hospital discharge. Although long-term survival in these groups is less than their shockable or cardiac aetiology counterparts, nearly half are alive 5 years following discharge. The findings support efforts to improve resuscitation care for those with non-shockable rhythms or non-cardiac cause.
关于从院外心脏骤停中复苏后的长期预后，人们知之甚少，特别是与呈现的节律或骤停病因有关。我们根据呈现的节律和骤停病因调查了那些复苏后存活出院的患者的长期生存情况。
我们对 2001 年 1 月 1 日至 2009 年 12 月 31 日期间，在一个大型城市紧急医疗服务系统中从医院复苏并存活出院的所有非创伤性成人院外心脏骤停患者进行了队列研究。使用调度、EMS 和医院记录收集有关人口统计学、情况、呈现的骤停节律和病因的信息。通过 2010 年 12 月 31 日的州死亡记录和社会安全死亡索引确定长期生命状态。我们使用 Kaplan-Meier 评估生存情况。
在研究期间，共有 1001/5958（17%）人被复苏并存活出院，其中 313/1001（31%）呈现非电击性节律，210/1001（21%）具有非心脏病因。总体中位生存时间为 9.8 年，64%的人存活时间超过 5 年。非电击性节律的 5 年生存率为 43%，而可电击性节律为 73%，非心脏病因的 5 年生存率为 45%，而心脏病因的 5 年生存率为 69%（分别为 p<0.001）。
非电击性节律或非心脏病因导致的心脏骤停构成了那些存活至出院的人中的相当大一部分。尽管这些人群的长期生存情况不如可电击性或心脏病因的患者，但近一半的人在出院后 5 年内仍然存活。这些发现支持努力改善对非电击性节律或非心脏病因患者的复苏护理。
