Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark.
Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark; Psychiatric Center Amager, Copenhagen University Hospital, Copenhagen, Denmark.
Resuscitation. 2019 Oct;143:180-188. doi: 10.1016/j.resuscitation.2019.07.008. Epub 2019 Jul 17.
To investigate whether the recent improvements in pre-hospital cardiac arrest-management and survival following out-of-hospital cardiac arrest (OHCA) also apply to OHCA patients with psychiatric disorders.
We identified all adult Danish patients with OHCA of presumed cardiac cause, 2001-2015. Psychiatric disorders were defined by hospital diagnoses up to 10 years before OHCA and analyzed as one group as well as divided into five subgroups (schizophrenia-spectrum disorders, bipolar disorder, depression, substance-induced mental disorders, other psychiatric disorders). Association between psychiatric disorders and pre-hospital OHCA-characteristics and 30-day survival were assessed by multiple logistic regression.
Of 27,523 OHCA-patients, 4772 (17.3%) had a psychiatric diagnosis. Patients with psychiatric disorders had lower odds of 30-day survival (0.37 95% confidence interval 0.32-0.43) compared with other OHCA-patients. Likewise, they had lower odds of witnessed status (0.75 CI 0.70-0.80), bystander cardiopulmonary resuscitation (CPR) (0.77 CI 0.72-0.83), shockable heart rhythm (0.37 95% CI, 0.33-0.40), and return of spontaneous circulation (ROSC) at hospital arrival (0.66 CI 0.59-0.72). Similar results were seen in all five psychiatric subgroups. The difference in 30-day survival between patients with and without psychiatric disorders increased in recent years: from 8.4% (CI 7.0-10.0%) in 2006 to 13.9% (CI 12.4-15.4%) in 2015 and from 7.0% (4.3-10.8%) in 2006 to 7.0% (CI 4.5-9.7%) in 2015, respectively.
Patients with psychiatric disorders have lower survival following OHCA compared to non-psychiatric patients and the gap between the two groups has widened over time.
调查院外心脏骤停（OHCA）管理和复苏后生存率的近期改善是否也适用于患有精神疾病的 OHCA 患者。
我们确定了 2001 年至 2015 年所有丹麦成人 OHCA 假定为心源性病因的患者。精神疾病通过 OHCA 前 10 年的住院诊断定义，并作为一个组进行分析，也分为五个亚组（精神分裂症谱系障碍、双相情感障碍、抑郁症、物质引起的精神障碍、其他精神障碍）。通过多变量逻辑回归评估精神疾病与院前 OHCA 特征和 30 天生存率之间的关系。
在 27523 例 OHCA 患者中，4772 例（17.3%）有精神科诊断。与其他 OHCA 患者相比，患有精神疾病的患者 30 天生存率较低（0.37[95%置信区间 0.32-0.43]）。同样，他们目击状态（0.75[CI 0.70-0.80]）、旁观者心肺复苏（CPR）（0.77[CI 0.72-0.83]）、可电击心律（0.37[95%CI，0.33-0.40]）和到达医院时自主循环恢复（ROSC）（0.66[CI 0.59-0.72]）的可能性较低。在所有五个精神科亚组中均观察到类似的结果。患有和不患有精神疾病的患者之间 30 天生存率的差异在近年来有所增加：从 2006 年的 8.4%（CI 7.0-10.0%）增加到 2015 年的 13.9%（CI 12.4-15.4%），从 2006 年的 7.0%（4.3-10.8%）增加到 2015 年的 7.0%（CI 4.5-9.7%）。
与非精神病患者相比，患有精神疾病的 OHCA 患者的生存率较低，并且两组之间的差距随着时间的推移而扩大。
