Department of Emergency Medicine, General Hospital of Vienna, Medical University of Vienna, Austria.
Resuscitation. 2012 Oct;83(10):1206-11. doi: 10.1016/j.resuscitation.2012.05.001. Epub 2012 May 14.
To evaluate the relationship between cause and outcome of in-hospital cardiac arrest.
Retrospective analysis of resuscitation data, causes of cardiac arrest and outcome with a follow-up to 6 months of a cardiac arrest registry in an emergency department of a tertiary care hospital, covering a 17.5-year period.
Of 1041 patients, 653 were male (63%), the median age was 64 years (IQR 53-73), 51% suffered cardiac arrest in the emergency department. The first recorded rhythm showed PEA in 432 (41%), ventricular fibrillation in 404 (39%) and asystole in 205 (20%) patients. Cardiac arrest of cardiac origin occurred in 63% of all patients, with 35% of them due to acute myocardial infarction. Non-cardiac causes were mostly due to pulmonary causes (15% of all patients). Aortic dissection/rupture, exsanguination, intoxication and adverse drug reactions, metabolic, cerebral, sepsis and accidental hypothermia each ranged between 1 and 4% of the cohort. Of all patients, 376 (36%) were discharged in good neurologic condition. Overall, patients with cardiac causes had a significantly better outcome than those with non-cardiac causes (44% vs. 23%, p<0.01). Patients with pulmonary causes survived in 24%. The other subgroups showed widely divergent survival results (3-65%). Patients who had suffered cardiac arrest in the emergency department had a better outcome then patients of the regular ward or radiology department.
In hospital cardiac arrest is caused mainly by cardiac and pulmonary causes, outcome depends on the cause, with a big variability.
评估院内心脏骤停的病因与结果之间的关系。
对复苏数据、心脏骤停的原因和结果进行回顾性分析，并对一家三级医院急诊科的心脏骤停登记处进行了 6 个月的随访，该登记处涵盖了 17.5 年的时间。
在 1041 名患者中，653 名男性（63%），中位年龄为 64 岁（IQR 53-73），51%的患者在急诊科发生心脏骤停。首次记录的节律显示 432 例（41%）为电机械分离，404 例（39%）为心室颤动，205 例（20%）为心搏骤停。所有患者中心脏性心脏骤停占 63%，其中 35%由急性心肌梗死引起。非心脏性原因主要由肺部原因引起（占所有患者的 15%）。主动脉夹层/破裂、出血、中毒和药物不良反应、代谢、脑、脓毒症和意外低体温各占队列的 1-4%。所有患者中，376 例（36%）出院时神经功能良好。总的来说，心脏原因引起的患者比非心脏原因引起的患者预后要好（44%比 23%，p<0.01）。肺部原因引起的患者存活率为 24%。其他亚组的生存率差异很大（3-65%）。在急诊科发生心脏骤停的患者比普通病房或放射科的患者预后要好。
院内心脏骤停主要由心脏和肺部原因引起，结果取决于病因，具有很大的变异性。
