Al-Dury Nooraldeen, Rawshani Araz, Israelsson Johan, Strömsöe Anneli, Aune Solveig, Agerström Jens, Karlsson Thomas, Ravn-Fischer Annica, Herlitz Johan
University of Gothenburg, Institute of Medicine, Sahlgrenska Academy, Sweden; Sahlgrenska University Hospital, Dept. of Medicine, Gothenburg, Sweden.
University of Gothenburg, Institute of Medicine, Sahlgrenska Academy, Sweden.
Am J Emerg Med. 2017 Dec;35(12):1839-1844. doi: 10.1016/j.ajem.2017.06.012. Epub 2017 Jun 7.
To investigate characteristics and outcome among patients suffering in-hospital cardiac arrest (IHCA) with the emphasis on gender and age.
Using the Swedish Register of Cardiopulmonary Resuscitation, we analyzed associations between gender, age and co-morbidities, etiology, management, 30-day survival and cerebral function among survivors in 14,933 cases of IHCA. Age was divided into three ordered categories: young (18-49years), middle-aged (50-64years) and older (65years and above). Comparisons between men and women were age adjusted.
The mean age was 72.7years and women were significantly older than men. Renal dysfunction was the most prevalent co-morbidity. Myocardial infarction/ischemia was the most common condition preceding IHCA, with men having 27% higher odds of having MI as the underlying etiology. A shockable rhythm was found in 31.8% of patients, with men having 52% higher odds of being found in VT/VF. After adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30days. Older individuals were managed less aggressively than younger patients. Increasing age was associated with lower 30-day survival but not with poorer cerebral function among survivors.
When adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30days after in-hospital cardiac arrest. Older individuals were managed less aggressively than younger patients, despite a lower chance of survival. Higher age was, however, not associated with poorer cerebral function among survivors.
调查住院心脏骤停（IHCA）患者的特征及预后，重点关注性别和年龄。
利用瑞典心肺复苏登记系统，我们分析了14933例IHCA患者中性别、年龄与合并症、病因、治疗、30天生存率及幸存者脑功能之间的关联。年龄分为三个有序类别：年轻（18 - 49岁）、中年（50 - 64岁）和老年（65岁及以上）。对男性和女性进行比较时进行了年龄调整。
平均年龄为72.7岁，女性明显比男性年龄大。肾功能不全是最常见的合并症。心肌梗死/缺血是IHCA前最常见的情况，男性患心肌梗死作为潜在病因的几率高27%。31.8%的患者出现可电击心律，男性出现室性心动过速/心室颤动的几率高52%。在调整各种混杂因素后，发现男性30天生存率比女性低10%。老年患者的治疗不如年轻患者积极。年龄增加与30天生存率降低相关，但与幸存者的脑功能较差无关。
在调整各种混杂因素后，发现住院心脏骤停后男性30天生存率比女性低10%。老年患者的治疗不如年轻患者积极，尽管生存率较低。然而，年龄较大与幸存者的脑功能较差无关。
