Roberts D, Landolfo K, Light R B, Dobson K
Section of Critical Care Medicine, University of Manitoba, Winnipeg, Canada.
Chest. 1990 Feb;97(2):413-9. doi: 10.1378/chest.97.2.413.
Few if any prearrest or intraarrest variables have been identified as highly predictive of inhospital mortality following cardiopulmonary arrest. A total of 310 consecutive patients requiring advanced cardiac life support during the calendar years 1985 and 1986 were reviewed with respect to eight specific variables. These included age, diagnosis, location, mechanism of the event, duration of resuscitation, whether the event was witnessed or unwitnessed, the initial observed rhythm and medications administered. A total of 37.1 percent of the patients were successfully resuscitated, but only 9.7 percent survived until discharge. Factors strongly associated with inhospital mortality included unwitnessed events (p = 0.0316), the need for epinephrine (p = 0.0003), identification of electromechanical dissociation or asystole as initial rhythms (p = 0.0000), and cardiac vs respiratory mechanism of arrest (p = 0.0000).
几乎没有(即便有也极少)心脏骤停前或心脏骤停期间的变量被确定为对心肺骤停后院内死亡率具有高度预测性。对1985年和1986年期间连续310例需要高级心脏生命支持的患者就八个特定变量进行了回顾。这些变量包括年龄、诊断、发病地点、事件机制、复苏持续时间、事件是否有目击者、最初观察到的心律以及使用的药物。共有37.1%的患者成功复苏,但只有9.7%存活至出院。与院内死亡率密切相关的因素包括无目击者事件(p = 0.0316)、需要使用肾上腺素(p = 0.0003)、初始心律为电机械分离或心搏停止(p = 0.0000)以及心脏骤停与呼吸骤停机制(p = 0.0000)。