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院外心脏骤停患者自主循环恢复后转至心脏骤停综合后综合征护理中心的生存及神经学转归:心脏骤停中心的另一可行性

Survival and neurologic outcomes of out-of-hospital cardiac arrest patients who were transferred after return of spontaneous circulation for integrated post-cardiac arrest syndrome care: the another feasibility of the cardiac arrest center.

作者信息

Kang Mun Ju, Lee Tae Rim, Shin Tae Gun, Sim Min Seob, Jo Ik Joon, Song Keun Jeong, Jeong Yeon Kwon

机构信息

Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2014 Sep;29(9):1301-7. doi: 10.3346/jkms.2014.29.9.1301. Epub 2014 Sep 2.

Abstract

It has been proven that safety and efficiency of out-of-hospital cardiac arrest (OHCA) patients is transported to specialized hospitals that have the capability of performing therapeutic hypothermia (TH). However, the outcome of the patients who have been transferred after return of spontaneous circulation (ROSC) has not been well evaluated. We conducted a retrospective observational study between January 2010 to March 2012. There were primary outcomes as good neurofunctional status at 1 month and the secondary outcomes as the survivals at 1 month between Samsung Medical Center (SMC) group and transferred group. A total of 91 patients were enrolled this study. There was no statistical difference between good neurologic outcomes between both groups (38% transferred group vs. 40.6% SMC group, P=0.908). There was no statistical difference in 1 month survival between the 2 groups (66% transferred group vs. 75.6% SMC group, P=0.318). In the univariate and multivariate models, the ROSC to induction time and the induction time had no association with good neurologic outcomes. The good neurologic outcome and survival at 1 month had no significant differences between the 2 groups. This finding suggests the possibility of integrated post-cardiac arrest care for OHCA patients who are transferred from other hospitals after ROSC in the cardiac arrest center.

摘要

已证实,院外心脏骤停(OHCA)患者被转运至有能力进行治疗性低温(TH)的专科医院时,安全性和效率更高。然而,自主循环恢复(ROSC)后被转运患者的结局尚未得到充分评估。我们在2010年1月至2012年3月期间进行了一项回顾性观察研究。主要结局为1个月时神经功能状态良好,次要结局为三星医疗中心(SMC)组和转运组1个月时的生存率。本研究共纳入91例患者。两组间神经功能良好结局无统计学差异(转运组38% vs. SMC组40.6%,P = 0.908)。两组间1个月生存率无统计学差异(转运组66% vs. SMC组75.6%,P = 0.318)。在单因素和多因素模型中,ROSC至诱导时间和诱导时间与良好的神经功能结局无关。两组间1个月时良好的神经功能结局和生存率无显著差异。这一发现提示,对于心脏骤停中心ROSC后从其他医院转运来的OHCA患者,有可能进行综合的心脏骤停后护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21e7/4168186/d03a884ce956/jkms-29-1301-g001.jpg

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