Department of Cardiology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
Resuscitation. 2013 May;84(5):569-74. doi: 10.1016/j.resuscitation.2012.10.009. Epub 2012 Oct 17.
Out-of-hospital cardiac arrest (OHCA) due to sustained ventricular tachycardia/fibrillation (VT/VF) is common and often lethal. Patient's co-morbidities may determine survival after OHCA, and be instrumental in post-resuscitation care, but are poorly studied. We aimed to study whether patients with obstructive pulmonary disease (OPD) have a lower survival rate after OHCA than non-OPD patients.
We performed a community-based cohort study of 1172 patients with non-traumatic OHCA with ECG-documented VT/VF between 2005 and 2008. We compared survival to emergency room (ER), to hospital admission, to hospital discharge, and at 30 days after OHCA, of OPD-patients and non-OPD patients, using logistic regression analysis. We also compared 30-day survival of patients who were admitted to hospital, using multivariate logistic regression analysis.
OPD patients (n=178) and non-OPD patients (n=994) had comparable survival to ER (75% vs. 78%, OR 0.9 [95% CI: 0.6-1.3]) and to hospital admission (56% vs. 57%, OR 1.0 [0.7-1.4]). However, survival to hospital discharge was significantly lower among OPD patients (21% vs. 33%, OR 0.6 [0.4-0.9]). Multivariate regression analysis among patients who were admitted to hospital (OPD: n=100, no OPD: n=561) revealed that OPD was an independent determinant of reduced 30-day survival rate (39% vs. 59%, adjusted OR 0.6 [0.4-1.0, p=0.035]).
OPD-patients had lower survival rates after OHCA than non-OPD patients. Survival to ER and to hospital admission was not different between both groups. However, among OHCA victims who survived to hospital admission, OPD was an independent determinant of reduced 30-day survival rate.
院外心脏骤停（OHCA）由于持续性室性心动过速/颤动（VT/VF）很常见，且通常是致命的。患者的合并症可能决定 OHCA 后的生存率，并对复苏后护理至关重要，但研究甚少。我们旨在研究阻塞性肺疾病（OPD）患者在 OHCA 后是否比非 OPD 患者的生存率更低。
我们对 2005 年至 2008 年间心电图记录为 VT/VF 的 1172 例非创伤性 OHCA 患者进行了一项基于社区的队列研究。我们使用逻辑回归分析比较了 OPD 患者和非 OPD 患者在急诊室（ER）、住院、出院和 OHCA 后 30 天的生存率，比较了住院患者的 30 天生存率，使用多变量逻辑回归分析。
OPD 患者（n=178）和非 OPD 患者（n=994）在 ER（75% vs. 78%，OR 0.9 [95% CI：0.6-1.3]）和住院（56% vs. 57%，OR 1.0 [0.7-1.4]）的生存率无差异。然而，OPD 患者的出院生存率显著较低（21% vs. 33%，OR 0.6 [0.4-0.9]）。在住院患者中进行多变量回归分析（OPD：n=100，非 OPD：n=561）表明，OPD 是 30 天生存率降低的独立决定因素（39% vs. 59%，调整 OR 0.6 [0.4-1.0，p=0.035]）。
与非 OPD 患者相比，OPD 患者在 OHCA 后生存率较低。两组患者在 ER 和住院的生存率无差异。然而，在 OHCA 幸存者中，OPD 是 30 天生存率降低的独立决定因素。
