Fontanals Jaume, Magaldi Marta, Caballero Ángel, Fontanals Montserrat
Servicio de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, España.
Servicio de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, España.
Med Clin (Barc). 2016 Jul 15;147(2):49-55. doi: 10.1016/j.medcli.2016.04.014. Epub 2016 May 26.
The aim of this study is to analyse in-hospital cardiopulmonary arrests (CA) that took place in conventional wards and evaluate their prognostic factors.
Retrospective review of in-hospital CA which occurred in our hospital over a 9-year period. CA that took place in intensive care areas, emergency rooms and operating theatres were excluded from the study. The following data were collected: demographic data, cause and initial rhythm of CA, internal control data, time, place, methods and results after cardiopulmonary resuscitation (CPR) (recovery of spontaneous circulation, [ROSC], and survival at discharge [SAD]) and neurologic performance at discharge. Results were analysed with SPSS(®) v. 20 predictive analytics software.
Average age was 66.9±17.5 years; 63.5% male. CA team arrived in 1.75±0.74min on average, and the average length of CPR was 25.8±16.10min. First rhythm: a) shockable rhythms=22.1%; b) asystole=66.2%, and c) pulseless electrical activity=11.7%. ROSC=51% and SAD=24.8%. Factors associated with a better prognostic (P<.05): age, reason for hospital admission, patient's previous physical condition, principal cause of CA, number of defibrillations and average length of CPR.
Despite having studied several variables as prognostic factors for CA and some of them being statistically significant, early prediction for survival for an in-hospital CA remains uncertain. Our study suggests that applying rational organisational measures, 25% of in-hospital CA could be discharged from hospital in good condition, and therefore, these organisational and educational measures should be extended to large hospitals.
本研究旨在分析发生在普通病房的院内心肺骤停（CA）情况，并评估其预后因素。
回顾性分析我院9年间发生的院内CA。本研究排除了重症监护病房、急诊室和手术室发生的CA。收集以下数据：人口统计学数据、CA的病因和初始心律、内部控制数据、心肺复苏（CPR）后的时间、地点、方法和结果（自主循环恢复[ROSC]以及出院存活[SAD]）以及出院时的神经功能表现。结果采用SPSS(®) v. 20预测分析软件进行分析。
平均年龄为66.9±17.5岁；男性占63.5%。CA团队平均在1.75±0.74分钟内到达，CPR平均时长为25.8±16.10分钟。初始心律：a）可除颤心律=22.1%；b）心搏停止=66.2%，c）无脉电活动=11.7%。ROSC=51%，SAD=24.8%。与较好预后相关的因素（P<0.05）：年龄、入院原因、患者既往身体状况、CA的主要病因、除颤次数和CPR平均时长。
尽管研究了多个作为CA预后因素的变量，其中一些具有统计学意义，但院内CA存活的早期预测仍然不确定。我们的研究表明，通过采取合理的组织措施，25%的院内CA患者可以康复出院，因此，这些组织和教育措施应推广至大型医院。
