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泰国一家三级护理医院院内心脏骤停心肺复苏术后的长期预后及生存预测因素

Long-term outcomes and predictors of survival after cardiopulmonary resuscitation for in-hospital cardiac arrest in a tertiary care hospital in Thailand.

作者信息

Limpawattana Panita, Aungsakul Wannaporn, Suraditnan Chomchanok, Panitchote Anupol, Patjanasoontorn Boonsong, Phunmanee Anakapong, Pittayawattanachai Nittaya

机构信息

Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

出版信息

Ther Clin Risk Manag. 2018 Mar 20;14:583-589. doi: 10.2147/TCRM.S157483. eCollection 2018.

Abstract

BACKGROUND

There are limited data available regarding long-term survival and its predictors in cases of in-hospital cardiac arrest (IHCA) in which patients receive cardiopulmonary resuscitation.

PURPOSE

The objectives of this study were to determine the 1-year survival rates and predictors of survival after IHCA.

PATIENTS AND METHODS

Data were retrospectively collected on all adult patients who were administered cardiopulmonary resuscitation from January 1, 2013 to December 31, 2014 in Srinagarind Hospital (Thailand). Clinical outcomes of interest and survival at discharge and 1 year after hospitalization were reviewed. Descriptive statistics and survival analysis were used to analyze the outcomes.

RESULTS

Of the 202 patients that were included, 48 (23.76%) were still alive at hospital discharge and 17 (about 8%) were still alive at 1 year post cardiac arrests. The 1-year survival rate for the cardiac arrest survivors post hospital discharge was 72.9%. Prearrest serum HCO<20 meq/L, asystole, urine <800 cc/d, postarrest coma, and absence of pupillary reflex were predictors of death.

CONCLUSION

Only 7.9% of patients with IHCA were alive 1 year following cardiac arrest. Prearrest serum HCO<20 meq/L, asystole, urine <800 cc/d, postarrest coma, and absence of pupillary reflex were the independent factors that predicted long-term mortality.

摘要

背景

关于接受心肺复苏的院内心脏骤停(IHCA)患者的长期生存情况及其预测因素,现有数据有限。

目的

本研究的目的是确定院内心脏骤停后的1年生存率及生存预测因素。

患者与方法

回顾性收集2013年1月1日至2014年12月31日在泰国诗里拉吉医院接受心肺复苏的所有成年患者的数据。评估感兴趣的临床结局以及出院时和住院1年后的生存情况。采用描述性统计和生存分析来分析结局。

结果

纳入的202例患者中,48例(23.76%)出院时仍存活,17例(约8%)心脏骤停后1年仍存活。心脏骤停幸存者出院后的1年生存率为72.9%。心脏骤停前血清碳酸氢根<20 meq/L、心搏停止、尿量<800 cc/天、心脏骤停后昏迷以及无瞳孔反射是死亡的预测因素。

结论

院内心脏骤停患者心脏骤停后1年仅有7.9%存活。心脏骤停前血清碳酸氢根<20 meq/L、心搏停止、尿量<800 cc/天、心脏骤停后昏迷以及无瞳孔反射是预测长期死亡率的独立因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de40/5865579/052ef82eae57/tcrm-14-583Fig1.jpg

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