von Auenmueller Katharina Isabel, Christ Martin, Sasko Benjamin Michel, Trappe Hans-Joachim
Department of Cardiology and Angiology, Marien Hospital Herne, Ruhr-University Bochum, Hoelkeskampring 40, Herne 44625, Germany.
J Emerg Trauma Shock. 2017 Jul-Sep;10(3):134-139. doi: 10.4103/JETS.JETS_146_16.
Sudden cardiac death is one of the leading causes of death in Europe, and early prognostication remains challenging. There is a lack of valid parameters for the prediction of survival after cardiac arrest.
This study aims to investigate if arterial blood gas parameters correlate with mortality of patients after out-of-hospital cardiac arrest.
All patients who were admitted to our hospital after resuscitation following out-of-hospital cardiac arrest between January 1, 2008, and December 31, 2013, were included in this retrospective study. The patient's survival 5 days after resuscitation defined the study end-point. For the statistical analysis, the mean, standard deviation, Student's -test, Chi-square test, and logistic regression analyses were used (level of significance < 0.05).
Arterial blood gas samples were taken from 170 patients. In particular, pH < 7.0 (odds ratio [OR]: 7.20; 95% confidence interval [CI]: 3.11-16.69; < 0.001) and lactate ≥ 5.0 mmol/L (OR: 6.79; 95% CI: 2.77-16.66; < 0.001) showed strong and independent correlations with mortality within the first 5 days after hospital admission.
Our study results indicate that several arterial blood gas parameters correlate with mortality of patients after out-of-hospital resuscitation. The most relevant parameters are pH and lactate because they are strongly and independently associated with mortality within the first 5 days after resuscitation. Despite this correlation, none of these parameters by oneself is strong enough to allow an early prognostication. Still, these parameters can contribute as part of a multimodal approach to assessing the patients' prognosis.
心脏性猝死是欧洲主要的死亡原因之一,早期预后评估仍然具有挑战性。目前缺乏用于预测心脏骤停后生存情况的有效参数。
本研究旨在调查动脉血气参数是否与院外心脏骤停患者的死亡率相关。
本回顾性研究纳入了2008年1月1日至2013年12月31日期间院外心脏骤停复苏后入住我院的所有患者。复苏后5天患者的生存情况定义为研究终点。统计分析采用均值、标准差、t检验、卡方检验和逻辑回归分析(显著性水平<0.05)。
从170例患者中采集了动脉血气样本。特别是,pH<7.0(比值比[OR]:7.20;95%置信区间[CI]:3.11 - 16.69;<0.001)和乳酸≥5.0 mmol/L(OR:6.79;95%CI:2.77 - 16.66;<0.001)与入院后前5天内的死亡率显示出强烈且独立的相关性。
我们的研究结果表明,几个动脉血气参数与院外复苏后患者的死亡率相关。最相关的参数是pH和乳酸,因为它们与复苏后前5天内的死亡率密切且独立相关。尽管存在这种相关性,但这些参数单独使用时都不足以进行早期预后评估。不过,这些参数可作为多模式评估患者预后方法的一部分发挥作用。