Balcı Kevser Gülcihan, Balcı Mustafa Mücahit, Şen Fatih, Akboğa Mehmet Kadri, Kalender Erol, Yılmaz Samet, Maden Orhan, Selçuk Hatice, Selçuk Timur, Temizhan Ahmet
Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2017 Apr;45(3):254-260. doi: 10.5543/tkda.2017.68480.
Despite recent advances in medical support and interventions, only 5% to 10% of patients with out-of-hospital cardiac arrest (OHCA) survive to discharge. In this study, factors related to neurologically favorable survival in patients with OHCA were analyzed.
A total of 129 patients who were admitted to hospital with OHCA were retrospectively enrolled.
Sustained return of spontaneous circulation (ROSC) (ROSC lasting >20 min) was achieved in 29 (22.4%) patients. Percentage of cardiac arrests with ischemic etiology was significantly higher in successful ROSC group (p<0.001). In multivariate logistic regression analysis, cardiac arrest with ischemic etiology (p=0.004) and cardiopulmonary resuscitation (CPR) duration (p=0.013) were found to be independent predictors for ROSC. One-minute increment in CPR duration was associated with 1.202-fold increase in failure to achieve ROSC. Among patients with ROSC, 7 (5.4%) survived to hospital discharge, and 1-minute increment in CPR duration was associated with a 1.123-fold decrease in neurologically favorable survival (p=0.005).
In patients with OHCA, ischemic etiology is associated with better ROSC rate compared to other reasons for cardiac arrest, and patients with prolonged CPR are less likely to survive.
尽管近期在医疗支持和干预方面取得了进展，但院外心脏骤停（OHCA）患者中只有5%至10%能存活至出院。本研究分析了OHCA患者神经功能良好存活的相关因素。
回顾性纳入了129例因OHCA入院的患者。
29例（22.4%）患者实现了自主循环持续恢复（ROSC）（ROSC持续时间>20分钟）。成功实现ROSC组中缺血性病因导致的心脏骤停百分比显著更高（p<0.001）。在多因素逻辑回归分析中，缺血性病因导致的心脏骤停（p=0.004）和心肺复苏（CPR）持续时间（p=0.013）被发现是ROSC的独立预测因素。CPR持续时间每增加1分钟，未实现ROSC的几率增加1.202倍。在实现ROSC的患者中，7例（5.4%）存活至出院，CPR持续时间每增加1分钟，神经功能良好存活的几率降低1.123倍（p=0.005）。
在OHCA患者中，与心脏骤停的其他原因相比，缺血性病因与更高的ROSC率相关，且CPR时间延长的患者存活可能性较小。
