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在一家地区医院队列中发生院内心搏骤停后的短期和长期生存。

Short and long-term survival following an in-hospital cardiac arrest in a regional hospital cohort.

机构信息

School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Intensive Care Unit, Bendigo Health, Australia.

Intensive Care Unit, Bendigo Health, Australia.

出版信息

Resuscitation. 2019 Oct;143:134-141. doi: 10.1016/j.resuscitation.2019.08.028. Epub 2019 Aug 27.

Abstract

INTRODUCTION

Evidence about the immediate survival from in-hospital cardiac arrest (IHCA) is well established, however, beyond discharge there is very little describing the long-term outcomes of these patients. Of the few existing studies, all have been conducted in metropolitan centres. Therefore, this study describes survival from IHCA in both the short and long-term in a large regional hospital cohort.

METHOD

A retrospective cohort study was conducted including all adult patients who suffered an IHCA between 1 February 2000 and 31 December 2017 in a large regional (non-metropolitan) hospital in Victoria, Australia. Characteristics of the arrest and patient were sourced from a prospectively collected database that captures all of the arrests occurring in the hospital. Mortality data after discharge were sourced from the state death registry, censored on 31 January 2018.

RESULTS

A total of 629 patients were included in the study. Of these, 357 (57%) survived the event, and 213 (34%) survived to discharge. At one-year post-arrest 27% of the original cohort were still alive. The age of the patient, arrest rhythm, location and duration of resuscitation were all significantly associated with long-term survival.

CONCLUSION

Both short and long-term survival following an IHCA in a regional hospital are similar to previously described rates in metropolitan hospitals. Further research is required on the post-discharge correlates of long-term survival.

摘要

简介

院内心搏骤停(IHCA)的即时存活率已有充分证据,但出院后很少有研究描述这些患者的长期预后。为数不多的现有研究均在大都市中心进行。因此,本研究描述了在澳大利亚维多利亚州一家大型地区性医院的大型队列中,IHCA 患者的短期和长期存活率。

方法

本研究采用回顾性队列研究,纳入了 2000 年 2 月 1 日至 2017 年 12 月 31 日期间在澳大利亚维多利亚州一家大型地区性(非大都市)医院发生 IHCA 的所有成年患者。从前瞻性收集的数据库中获取了与该事件相关的患者和发作特征,该数据库记录了医院内所有的发作事件。出院后的死亡率数据来源于州死亡登记处,截至 2018 年 1 月 31 日进行删失。

结果

共纳入 629 例患者。其中,357 例(57%)在事件中存活,213 例(34%)存活至出院。在发作后 1 年,原队列中有 27%的患者仍然存活。患者年龄、发作节律、发作地点和复苏持续时间均与长期存活率显著相关。

结论

地区性医院 IHCA 患者的短期和长期存活率与大都市医院描述的存活率相似。需要进一步研究出院后与长期存活率相关的因素。

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