Alzahrani Abdullah Hussain, Alnajjar Maumounah F, Alshamarni Hussien M, Alshamrani Hasan M, Bakhsh Abdullah A
Department of Emergency Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Department of Emergency Medicine, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
Saudi J Med Med Sci. 2019 Sep-Dec;7(3):156-162. doi: 10.4103/sjmms.sjmms_256_18. Epub 2019 Aug 28.
Sudden cardiac arrest (SCA) is a major cause of mortality, yet its epidemiological and outcome data in hospitals from Saudi Arabia are limited.
This study aimed to evaluate the prevalence, risk factors and outcomes of SCA in a teaching hospital in Jeddah, Saudi Arabia.
This retrospective study included all patients aged ≥18 years with SCA who were resuscitated at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between January 1 and December 31, 2016. Data were retrieved from the hospital medical records as flow sheets designed in accordance with the Utstein-style recommendations. Factors relating to mortality were analyzed using descriptive analyses and chi-square test.
A total of 429 cases of SCA met the inclusion criteria, and its prevalence was 7.76 cases/1000 adult hospital admission. Of these, 61.3% were male, and the mean age was 58.4 years, with 36.6% aged >65 years. Only 3.5% were outside-hospital cardiac arrests. The most common initial rhythm was pulseless electrical activity/asystole (93.2%), while ventricular tachycardia/ventricular fibrillation was documented in only 29 cases (6.8%). The overall rate of return to spontaneous circulation (ROSC) was 56.2%, and 56.8% in cases of in-hospital cardiac arrest (IHCA). Patients with SCA due to sepsis had significantly increased mortality ( < 0.000; odds ratio [OR] = 0.24 [0.12-0.47 95% confidence interval [CI]]), while those with SCA due to respiratory causes had significantly better survival outcomes ( = 0.001; OR = 2.3 [1.5-3.8 95% CI]). No significant differences in outcomes were found between other risk factors, including cardiac causes.
In this population, the prevalence of SCA in adults was higher than reported in many similar studies. Further, sepsis was found to affect the survival rate. Although the rate of ROSC for IHCA patients was favorable compared with other studies, it is relatively poor. This finding signifies the need to identify and control risk factors for SCA to improve survival.
心脏骤停（SCA）是主要的死亡原因，然而沙特阿拉伯医院中关于其流行病学和结局的数据有限。
本研究旨在评估沙特阿拉伯吉达一家教学医院中SCA的患病率、危险因素和结局。
这项回顾性研究纳入了2016年1月1日至12月31日期间在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院接受复苏的所有年龄≥18岁的SCA患者。数据从医院病历中检索，采用按照乌斯坦风格建议设计的流程图。使用描述性分析和卡方检验分析与死亡率相关的因素。
共有429例SCA符合纳入标准，其患病率为7.76例/1000例成人住院患者。其中，61.3%为男性，平均年龄为58.4岁，36.6%年龄>65岁。仅3.5%为院外心脏骤停。最常见的初始心律是无脉电活动/心搏停止（93.2%），而仅29例（6.8%）记录为室性心动过速/心室颤动。自主循环恢复（ROSC）的总体发生率为56.2%，院内心脏骤停（IHCA）患者为56.8%。因脓毒症导致SCA的患者死亡率显著增加（<0.000；比值比[OR]=0.24[0.12 - 0.47 95%置信区间[CI]]），而因呼吸原因导致SCA的患者生存结局显著更好（=0.001；OR = 2.3[1.5 - 3.8 95% CI]）。在包括心脏原因在内的其他危险因素之间，结局未发现显著差异。
在该人群中，成人SCA的患病率高于许多类似研究报告的结果。此外，发现脓毒症会影响生存率。尽管与其他研究相比，IHCA患者的ROSC发生率较好，但仍相对较低。这一发现表明需要识别和控制SCA的危险因素以提高生存率。
