Wiberg Sebastian, Holmberg Mathias J, Donnino Michael W, Kjaergaard Jesper, Hassager Christian, Witten Lise, Berg Katherine M, Moskowitz Ari, Andersen Lars W
Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
Resuscitation. 2020 Jun;151:189-196. doi: 10.1016/j.resuscitation.2020.03.008. Epub 2020 Apr 1.
While survival after in-hospital cardiac arrest (IHCA) has improved in recent years, it remains unknown whether this trend primarily applies to younger IHCA victims. The aim of this study was to assess trends in survival to hospital discharge after adult IHCA across age groups from 2000 to 2016.
This is an observational study of IHCA patients included in the Get With The Guidelines®-Resuscitation registry between 2000 and 2016. The primary outcome was survival to hospital discharge. Patients were stratified into five age groups: <50 years, 50-59 years, 60-69 years, 70-79 years, and ≥80 years. Generalized linear regression was used to obtain absolute survival rates over time.
A total of 234,767 IHCA patients were included. The absolute increase in survival per calendar year was 0.8% (95% CI 0.7-1.0%, p < 0.001) for patients younger than 50 years, 0.6% (95% CI 0.4-0.7%, p < 0.001) for patients between 50 and 59 years, 0.5% (95% CI 0.4-0.6%, p < 0.001) for patients between 60 and 69 years, 0.5% (95% CI 0.4-0.6%, p < 0.001) for patients between 70 and 79 years, and 0.5% (95% CI 0.4-0.6%, p < 0.001) for patients older than 80 years. We observed a significant interaction between calendar year and age group (p < 0.001), indicating that the rate of improvement in survival over time was significantly different between age groups.
For patients with IHCA, rates of survival to discharge have improved significantly from 2000 to 2016 across all age groups.
尽管近年来院内心脏骤停（IHCA）后的生存率有所提高，但这种趋势是否主要适用于年轻的IHCA患者仍不清楚。本研究的目的是评估2000年至2016年各年龄组成人IHCA后出院生存率的趋势。
这是一项对2000年至2016年纳入“遵循指南®-复苏”注册研究的IHCA患者的观察性研究。主要结局是出院生存率。患者被分为五个年龄组：<50岁、50-59岁、60-69岁、70-79岁和≥80岁。采用广义线性回归来获取随时间变化的绝对生存率。
共纳入234,767例IHCA患者。年龄小于50岁的患者每年生存率的绝对增幅为0.8%（95%CI 0.7-1.0%，p<0.001），50至59岁的患者为0.6%（95%CI 0.4-0.7%，p<0.001），60至69岁的患者为0.5%（95%CI 0.4-0.6%，p<0.001），70至79岁的患者为0.5%（95%CI 0.4-0.6%，p<0.001），80岁及以上的患者为0.5%（95%CI 0.4-0.6%，p<0.001）。我们观察到年份与年龄组之间存在显著交互作用（p<0.001），表明各年龄组生存率随时间的改善率存在显著差异。
对于IHCA患者，2000年至2016年期间所有年龄组的出院生存率均有显著提高。
