Lin Yu, Tsai Shih-Hung, Yang Chen-Shu, Wu Chun-Hsien, Huang Chih-Han, Lin Fu-Huang, Ku Chih-Hung, Chung Chi-Hsiang, Chien Wu-Chien, Lai Chung-Yu, Chu Chi-Ming
Graduate Institute of Life Sciences Department of Nursing, University of Kang Ning Department of Emergency Medicine Physical Examination Center, Kaohsiung Armed Forces General Hospital Gangshan Branch Division of Cardiology Division of Cardiovascular Surgery School of Public Health Department of Health Industry Management, Kainan University, Taoyuan City Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City Department of Healthcare Administration and Medical Informatics College of Health Sciences, Kaohsiung Medical University Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Medicine (Baltimore). 2018 Sep;97(37):e12382. doi: 10.1097/MD.0000000000012382.
Post-cardiac arrest care was implemented in 2010 and has been shown to improve the survival of patients with coronary heart disease (CHD). However, the findings varied for different survival conditions.We conducted a retrospective longitudinal study of records from 2007 to 2013 in the National Health Insurance Research Database. We evaluated the differences in short-term (2-day and 7-day) and long-term (30-day and survival to discharge) survival after the implementation of post-cardiac arrest care and among age subgroups. We reviewed inpatient datasets in accordance with the International Classification of Disease Clinical Modification, 9th revision codes (ICD-9-CM). Eligible participants were identified as those with simultaneous diagnoses of cardiac arrest (ICD-9-CM codes: 427.41 or 427.5) and CHD (ICD-9-CM codes: 410-414). Multiple logistic regression was applied to establish the relationship between calendar year and survival outcomes.The odds of 2-day survival from 2011 to 2013 were higher than those from 2007 to 2010 (adjusted odds ratio [aOR]: 1.15; 95% confidence interval [CI]: 1.03-1.29). Similarly, the odds of 7-day survival from 2011 to 2013 were higher than those from 2007 to 2010 (aOR: 1.11; 95% CI: 1.01-1.22). Improvements in the odds of 2-day and 7-day survival were discovered only in patients <65 years old. Our data reinforce that short-term survival improved after implementation of post-cardiac arrest care. However, older age seemed to nullify the influence of post-cardiac arrest care on survival.
心脏骤停后护理于2010年开始实施,已被证明可提高冠心病(CHD)患者的生存率。然而,不同生存条件下的研究结果有所不同。我们对国民健康保险研究数据库中2007年至2013年的记录进行了一项回顾性纵向研究。我们评估了实施心脏骤停后护理后以及不同年龄亚组之间短期(2天和7天)和长期(30天和出院生存率)生存的差异。我们根据国际疾病分类临床修订第9版编码(ICD-9-CM)对住院数据集进行了审查。符合条件的参与者被确定为同时诊断为心脏骤停(ICD-9-CM编码:427.41或427.5)和冠心病(ICD-9-CM编码:410-414)的患者。应用多元逻辑回归来建立历年与生存结果之间的关系。2011年至2013年2天生存的几率高于2007年至2010年(调整后的优势比[aOR]:1.15;95%置信区间[CI]:1.03-1.29)。同样,2011年至2013年7天生存的几率高于2007年至2010年(aOR:1.11;95%CI:1.01-1.22)。仅在65岁以下的患者中发现2天和7天生存几率有所改善。我们的数据证实,实施心脏骤停后护理后短期生存有所改善。然而,年龄较大似乎抵消了心脏骤停后护理对生存的影响。