Vancini-Campanharo Cassia Regina, Vancini Rodrigo Luiz, de Lira Claudio Andre Barbosa, Andrade Marília Dos Santos, Lopes Maria Carolina Barbosa Teixeira, Okuno Meiry Fernanda Pinto, Batista Ruth Ester Assayag, Atallah Álvaro Nagib, de Góis Aécio Flávio Teixeira
Paulista School of Nursing/Federal University of Sao Paulo, 754 Napoleao de Barros Street, São Paulo, SP 04024-002, Brazil.
Federal University of Espirito Santo, 173 Feliciano Bicudo Street, Sao Paulo, SP 02301-020, Brazil.
Indian J Med Res. 2016 Oct;144(4):552-559. doi: 10.4103/0971-5916.200898.
BACKGROUND & OBJECTIVES: Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality.
This prospective study was conducted at Emergency Department of São Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3±17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality.
Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation.
INTERPRETATION & CONCLUSIONS: The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.
心脏骤停（CA）因其病例数量众多及其社会和经济影响，成为医学面临的最大挑战之一。尽管心肺复苏（CPR）技术取得了进展，但数十年来死亡率并未显著下降。本研究旨在描述心脏骤停患者的特征，并确定与死亡率相关的因素。
本前瞻性研究在巴西圣保罗医院急诊科进行。285例心脏骤停患者在接受治疗后随访一年。平均年龄为66.3±17.2岁，主要为男性（55.8%）和白种人（71.9%）。死亡率及与死亡率相关的因素为主要和次要观察指标。数据通过院内Utstein式报告收集。采用逻辑回归分析确定哪些变量与死亡率相关。
关于心肺复苏的特征，76.5%发生在医院内，呼吸衰竭是最常见的推测心脏骤停直接原因（30.8%），无脉电活动是最常见的初始心律（58.7%）。所有心肺复苏尝试均采用胸外按压和通气，最常用的干预措施是肾上腺素（97.2%）和插管（68.5%）。在所有接受治疗的患者中，95.4%死亡。无脉电活动患者的死亡风险高于室颤患者。
该研究结果突出显示心脏骤停患者的死亡率很高。最能解释死亡率的变量是初始心脏骤停心律。
