根据一项国家紧急医疗服务数据库，肾上腺素的使用对于院外心脏骤停患者自主循环恢复而言并非良好的预测指标。
Adrenaline use as a poor predictor for the return of spontaneous circulation among victims of out-of-hospital cardiac arrest according to a national emergency medical services database.
作者信息
Yuksen Chaiyaporn, Phattharapornjaroen Phatthranit, Kreethep Woranee, Suwanmano Chonnakarn, Jenpanitpong Chestsadakon, Nonnongku Rawin, Sittichanbuncha Yuwares, Sawanyawisuth Kittisak
机构信息
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Khon Kaen University, Khon Kaen, Thailand.
出版信息
Turk J Emerg Med. 2020 Jan 28;20(1):18-21. doi: 10.4103/2452-2473.276382. eCollection 2020 Jan-Mar.
OBJECTIVE
This study aimed to determine additional predictors of cardiopulmonary resuscitation success using a national emergency medical services (EMS) database.
METHODS
This retrospective study was conducted by retrieving data from the Information Technology of Emergency Medical Service, a national EMS database. The inclusion criteria were adult patients (18 years old or over) who suffered from out-of-hospital cardiac arrest and received emergency life support. The outcome was a return of spontaneous circulation (ROSC). Predictors for ROSC were determined using multivariate logistic regression analysis.
RESULTS
During the study period, 1070 patients met the study criteria, among whom 199 (18.60%) belonged to the ROSC group. Five factors were eligible for multivariate logistic regression analysis for predicting ROSC. Accordingly, only adrenaline administration was independently and negatively associated with ROSC with an adjusted odds ratio of 0.722 (95% confidence interval: 0.522, 0.997) and a Hosmer-Lemeshow Chi-square of 5.84 ( = 0.665).
CONCLUSIONS
Adrenaline use may be a poor predictor for ROSC during out-of-hospital cardiac arrest.
目的
本研究旨在利用国家紧急医疗服务（EMS）数据库确定心肺复苏成功的其他预测因素。
方法
本回顾性研究通过从国家EMS数据库紧急医疗服务信息技术中检索数据进行。纳入标准为成年患者（18岁及以上），他们在院外心脏骤停并接受了紧急生命支持。结局为自主循环恢复（ROSC）。使用多因素逻辑回归分析确定ROSC的预测因素。
结果
在研究期间，1070例患者符合研究标准，其中199例（18.60%）属于ROSC组。五个因素符合多因素逻辑回归分析预测ROSC的条件。因此，只有肾上腺素的使用与ROSC独立且呈负相关，调整后的优势比为0.722（95%置信区间：0.522，0.997），Hosmer-Lemeshow卡方值为5.84（P = 0.665）。
结论
在院外心脏骤停期间，肾上腺素的使用可能是ROSC的不良预测因素。
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