Su Chih-Pei, Wu Jr-Hau, Yang Mei-Chueh, Liao Ching-Hui, Hsu Hsiu-Ying, Chang Chin-Fu, Lan Shou-Jen, Chu Chiao-Lee, Lin Yan-Ren
Department of Health Care Administration, Asia University, Taichung, Taiwan; Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan; Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan.
Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Biomed Res Int. 2017;2017:9259182. doi: 10.1155/2017/9259182. Epub 2017 Feb 13.
The outcome of patients suffering from out-of-hospital cardiac arrest (OHCA) is very poor, and postresuscitation comorbidities increase long-term mortality. This study aims to analyze new-onset postresuscitation comorbidities in patients who survived from OHCA for over one year. The Taiwan National Health Insurance (NHI) Database was used in this study. Study and comparison groups were created to analyze the risk of suffering from new-onset postresuscitation comorbidities from 2011 to 2012 (until December 31, 2013). The study group included 1,346 long-term OHCA survivors; the comparison group consisted of 4,038 matched non-OHCA patients. Demographics, patient characteristics, and risk of suffering comorbidities (using Cox proportional hazards models) were analyzed. We found that urinary tract infections ( = 225, 16.72%), pneumonia ( = 206, 15.30%), septicemia ( = 184, 13.67%), heart failure ( = 111, 8.25%) gastrointestinal hemorrhage ( = 108, 8.02%), epilepsy or recurrent seizures ( = 98, 7.28%), and chronic kidney disease ( = 62, 4.61%) were the most common comorbidities. Furthermore, OHCA survivors were at much higher risk (than comparison patients) of experiencing epilepsy or recurrent seizures (HR = 20.83; 95% CI: 12.24-35.43), septicemia (HR = 8.98; 95% CI: 6.84-11.79), pneumonia (HR = 5.82; 95% CI: 4.66-7.26), and heart failure (HR = 4.88; 95% CI: 3.65-6.53). Most importantly, most comorbidities occurred within the first half year after OHCA.
院外心脏骤停（OHCA）患者的预后非常差，复苏后合并症会增加长期死亡率。本研究旨在分析OHCA存活超过一年的患者新出现的复苏后合并症。本研究使用了台湾国民健康保险（NHI）数据库。创建了研究组和对照组，以分析2011年至2012年（至2013年12月31日）出现新的复苏后合并症的风险。研究组包括1346名长期OHCA幸存者；对照组由4038名匹配的非OHCA患者组成。分析了人口统计学、患者特征和合并症风险（使用Cox比例风险模型）。我们发现，尿路感染（n = 225，16.72%）、肺炎（n = 206，15.30%）、败血症（n = 184，13.67%）、心力衰竭（n = 111，8.25%）、胃肠道出血（n = 108，8.02%）、癫痫或反复癫痫发作（n = 98，7.28%）以及慢性肾病（n = 62，4.61%）是最常见的合并症。此外，OHCA幸存者发生癫痫或反复癫痫发作（HR = 20.83；95%CI：12.24 - 35.43）、败血症（HR = 8.98；95%CI：6.84 - 11.79）、肺炎（HR = 5.82；95%CI：4.66 - 7.26）和心力衰竭（HR = 4.88；95%CI：3.65 - 6.53）的风险比对照组患者高得多。最重要的是，大多数合并症发生在OHCA后的前半年内。
