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心肺复苏后孕妇与非孕妇死亡率的差异。

Differences in Mortality Between Pregnant and Nonpregnant Women After Cardiopulmonary Resuscitation.

作者信息

Mogos Mulubrhan F, Salemi Jason L, Spooner Kiara K, McFarlin Barbara L, Salihu Hamisu M

机构信息

Department of Women, Children and Family Health Science, College of Nursing, University of Illinois, Chicago, Illinois; and the Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas.

出版信息

Obstet Gynecol. 2016 Oct;128(4):880-888. doi: 10.1097/AOG.0000000000001629.

Abstract

OBJECTIVE

To examine the association between pregnancy status and in-hospital mortality after cardiopulmonary resuscitation (CPR) in an inpatient setting.

METHODS

We conducted a population-based cross-sectional study using the Nationwide Inpatient Sample databases (2002-2011). International Classification of Diseases, 9th Revision, Clinical Modification codes were used to define cases, comorbidities, and clinical outcomes. Rates of CPR among study groups were calculated by patient and hospital characteristics. Survey logistic regression was used to estimate adjusted odds ratios (ORs) that represent the association between pregnancy status and mortality after CPR. Joinpoint regression was used to describe temporal trends in CPR and mortality rates.

RESULTS

During the study period, 5,923 women (13-49 years) received inpatient CPR annually. Cardiopulmonary resuscitation rates increased significantly from 2002 to 2011, by 6.4% and 3.8% annually, for pregnant and nonpregnant women, respectively. In-hospital mortality rates after CPR were lower among pregnant women 49.4% (45.4-53.4) than nonpregnant women 71.1% (70.1-72.2), even after adjusting for confounders (adjusted OR 0.46, 95% confidence interval 0.39-0.56).

CONCLUSION

Cardiopulmonary resuscitation in an inpatient pregnant woman is associated with improved survival compared with this procedure in nonpregnant women. Elucidating reasons behind this association could help to improve CPR outcomes in both pregnant and nonpregnant women.

摘要

目的

探讨住院环境下妊娠状态与心肺复苏(CPR)后院内死亡率之间的关联。

方法

我们使用全国住院患者样本数据库(2002 - 2011年)进行了一项基于人群的横断面研究。采用国际疾病分类第九版临床修订本代码来定义病例、合并症和临床结局。根据患者和医院特征计算研究组中的心肺复苏率。使用调查逻辑回归来估计调整后的优势比(OR),以代表妊娠状态与心肺复苏后死亡率之间的关联。使用连接点回归来描述心肺复苏率和死亡率的时间趋势。

结果

在研究期间,每年有5923名年龄在13 - 49岁的女性接受住院心肺复苏。从2002年到2011年,心肺复苏率显著上升,孕妇和非孕妇的年增长率分别为6.4%和3.8%。心肺复苏后的院内死亡率在孕妇中为49.4%(45.4 - 53.4),低于非孕妇的71.1%(70.1 - 72.2),即使在调整混杂因素后(调整后的OR为0.46,95%置信区间为0.39 - 0.56)。

结论

与非孕妇相比,住院孕妇进行心肺复苏与生存率提高相关。阐明这种关联背后的原因有助于改善孕妇和非孕妇的心肺复苏结局。

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