Inokuchi Sadaki, Masui Yoshihiro, Miura Kunihisa, Tsutsumi Haruhiko, Takuma Kiyotsugu, Atsushi Ishihara, Nakano Minoru, Tanaka Hiroshi, Ikegami Keiichi, Arai Takao, Yaguchi Arino, Kitamura Nobuya, Oda Shigeto, Kobayashi Kenji, Suda Takayuki, Ono Kazuyuki, Morimura Naoto, Furuya Ryosuke, Koido Yuichi, Iwase Fumiaki, Nagao Ken, Kanesaka Shigeru, Okada Yasusei, Unemoto Kyoko, Sadahiro Tomohito, Iyanaga Masayuki, Muraoka Asaki, Hayashi Munehiro, Ishimatsu Shinichi, Miyake Yasufumi, Yokokawa Hideo, Koyama Yasuaki, Tsuchiya Asuka, Kashiyama Tetsuya, Hayashi Munetaka, Oshima Kiyohiro, Kiyota Kazuya, Hamabe Yuichi, Yokota Hiroyuki, Hori Shingo, Inaba Shin, Sakamoto Tetsuya, Harada Naoshige, Kimura Akio, Kanai Masayuki, Otomo Yasuhiro, Sugita Manabu, Kinoshita Kosaku, Sakurai Takatoshi, Kitano Mitsuhide, Matsuda Kiyoshi, Tanaka Kotaro, Yoshihara Katsunori, Yoh Kikuo, Suzuki Junichi, Toyoda Hiroshi, Mashiko Kunihiro, Shimizu Naoki, Muguruma Takashi, Shimada Tadanaga, Kobe Yoshiro, Shoko Tomohisa, Nakanishi Kazuya, Shiga Takashi, Yamamoto Takefumi, Sekine Kazuhiko, Izuka Shinichi
Tokai University School of Medicine.
St. Marianna University School of Medicine Yokohama Seibu Hospital.
Acute Med Surg. 2016 Mar 11;3(3):250-259. doi: 10.1002/ams2.183. eCollection 2016 Jul.
The prognosis of non-shockable out-of-hospital cardiac arrest is worse than that of shockable out-of-hospital cardiac arrest. We investigated the associations between the etiology and prognosis of non-shockable out-of-hospital cardiac arrest patients who experienced the return of spontaneous circulation after arriving at hospital.
All subjects were extracted from the SOS-KANTO 2012 study population. The subjects were 3,031 adults: (i) who had suffered out-of-hospital cardiac arrest, (ii) for whom there were no pre-hospital data on ventricular fibrillation/pulseless ventricular tachycardia until arrival at hospital, (iii) who experienced the return of spontaneous circulation after arriving at hospital. We compared the patients' prognosis after 1 and 3 months between various etiological and presumed cardiac factors. The proportion of the favorable brain function patients that developed pulmonary embolism or incidental hypothermia was significantly higher than that of the patients with presumed cardiac factors (1 month, < 0.0001 and < 0.0001, respectively; 3 months, = 0.0018 and < 0.0001, respectively). In multiple logistic regression analysis, pulmonary embolism and incidental hypothermia were found to be significant independent prognostic factors for 1- and 3-month survival and the favorable brain function rate.
In patients who suffer non-shockable out-of-hospital cardiac arrest, but who experience the return of spontaneous circulation after arriving at hospital, the investigation and treatment of pulmonary embolism as a potential etiology may be important for improving post-resuscitation prognosis.
院外非可电击心律心脏骤停的预后比可电击心律心脏骤停的预后更差。我们调查了院外非可电击心律心脏骤停患者到达医院后自主循环恢复的病因与预后之间的关联。
所有受试者均从SOS-KANTO 2012研究人群中提取。受试者为3031名成年人：（i）曾发生院外心脏骤停；（ii）在到达医院前无室颤/无脉性室性心动过速的院前数据；（iii）到达医院后经历了自主循环恢复。我们比较了不同病因和假定心脏因素患者1个月和3个月后的预后。发生肺栓塞或意外低温的脑功能良好患者的比例显著高于假定有心脏因素的患者（1个月时，分别为<0.0001和<0.0001；3个月时，分别为=0.0018和<0.0001）。在多因素逻辑回归分析中，发现肺栓塞和意外低温是1个月和3个月生存率及脑功能良好率的显著独立预后因素。
对于发生院外非可电击心律心脏骤停但到达医院后经历自主循环恢复的患者，将肺栓塞作为潜在病因进行调查和治疗可能对改善复苏后预后很重要。
