Kim Han Joon, Kim Gi Woon, Oh Sang Hoon, Park Sang Hyun, Choi Jae Hyung, Kim Kyung Hwan, Jeon Woo Chan, Lee Hui Jai, Park Kyu Nam
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Emergency Medicine, College of Medicine, Ajou University, Suwon, Republic of Korea.
Am J Emerg Med. 2014 Nov;32(11):1378-81. doi: 10.1016/j.ajem.2014.08.045. Epub 2014 Aug 27.
The aim of this study was to describe the epidemiology and outcomes of patients with therapeutic hypothermia after out-of-hospital cardiac arrest (OHCA) caused by self-inflicted intoxication.
We performed a multicenter retrospective registry-based study of adult OHCA patients presenting to 24 hospitals over 6 years across South Korea. Data included demographics, resuscitation variables, postresuscitation variables, and self-inflicted intoxicants. Neurologic outcomes were categorized according to the Glasgow-Pittsburgh Cerebral Performance Categories (CPC) scale and were dichotomized as either good discharge outcomes (CPC 1 and 2) or poor discharge outcomes (CPC 3-5).
A total of 930 OHCA cases were identified, 24 (2.6%) of which were classified as cardiac arrest caused by acute intoxication. The mean age of cases was 57.2 ± 12.9 years. The mean time from collapse to return of spontaneous circulation was 35.4 ± 18.7 minutes. The presenting rhythm was pulseless electrical activity in 6 patients (25%) and asystole in 18 patients (75%). Eleven patients (46%) survived to hospital discharge, and of these, good discharge outcomes (CPC 1 and 2) were achieved in 21% (5/24). For pesticide intoxication, the survival-to-discharge rate was 62% (8/13), and the rate of good neurologic outcome was 23% (3/13).
Patients with OHCA caused by self-inflicted intoxication represented 2.6% of all OHCA patients. They showed a high rate of unwitnessed cardiac arrest and a very low rate of bystander cardiopulmonary resuscitation. Pesticides were the main cause of cardiac arrest, and these cases had a very high discharge to survival rate.
本研究旨在描述因自我中毒导致院外心脏骤停（OHCA）患者的流行病学特征及预后情况。
我们对韩国24家医院6年间收治的成年OHCA患者进行了一项基于多中心回顾性登记的研究。数据包括人口统计学信息、复苏变量、复苏后变量以及自我中毒物质。神经功能预后根据格拉斯哥-匹兹堡脑功能分类（CPC）量表进行分类，并分为良好出院预后（CPC 1和2）或不良出院预后（CPC 3 - 5）。
共确定930例OHCA病例，其中24例（2.6%）被归类为急性中毒导致的心脏骤停。病例的平均年龄为57.2±12.9岁。从心脏停搏到自主循环恢复的平均时间为35.4±18.7分钟。就诊时的心律为无脉电活动的有6例患者（25%），心搏停止的有18例患者（75%）。11例患者（46%）存活至出院，其中21%（5/24）获得了良好的出院预后（CPC 1和2）。对于农药中毒，出院生存率为62%（8/13），良好神经功能预后率为23%（3/13）。
因自我中毒导致OHCA的患者占所有OHCA患者的2.6%。他们表现出较高的未被目击心脏骤停发生率和极低旁观者心肺复苏率。农药是心脏骤停的主要原因，且这些病例的出院生存率非常高。
