Yen Kun-Chi, Chan Yi-Hsin, Wu Chia-Tung, Hsieh Ming-Jer, Wang Chun-Li, Wen Ming-Shien, Chu Po-Hsien
The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
J Formos Med Assoc. 2021 Jan;120(1 Pt 2):551-558. doi: 10.1016/j.jfma.2020.07.004. Epub 2020 Jul 8.
BACKGROUND/PURPOSE: In-hospital cardiac arrest is a serious issue for hospitalized patients. The documented initial rhythm and detected medical events have been reported to influence the survival of cardiopulmonary resuscitation. This study aimed to identify the effect of continuous real-time electrocardiogram (ECG) monitoring on the prognosis of resuscitated patients in a general cardiac ward.
We conducted this retrospective study using medical records of hospitalized patients in a cardiovascular ward who experienced an in-hospital cardiac arrest and received cardiopulmonary resuscitation from February 2015 to December 2018. The patients who were considered to be at high risk of cardiac events such as ventricular arrhythmia would receive continuous ECG monitoring. A wireless ECG telemonitoring system was introduced to replace traditional bedside ECG monitors. The outcome measures were the initial success of resuscitation, 24-h survival after resuscitation, and survival to discharge.
We enrolled 115 patients with a cardiac arrest during hospitalization, of whom 73 (63%) patients received wireless ECG telemonitoring. Patients receiving continuous ECG monitoring were associated with higher opportunities of initial success of resuscitation and 24-h survival after resuscitation (67.1% vs. 40.5%, p = 0.005; and 49.3% vs. 26.2%, p = 0.015, respectively) when comparing to the non-monitoring group; but no significant difference in survival to discharge (21.9% vs. 16.7%, p = 0.498) was observed. With adjustment of the covariates, the monitoring group was associated with a higher likelihood to reach the initial success of resuscitation (odds ratios [ORs], 3.21; 95% confidence interval [CI], 1.03-9.98). However, the effect of monitoring on 24-h survival and survival to discharge was close to null after adjusting for covariates.
A wireless ECG telemonitoring system were beneficial to the initial success of resuscitation for patients at high risk of cardiovascular events suffering an in-hospital cardiac arrest; but had less impact on 24-h survival and survival to discharge.
背景/目的：院内心脏骤停是住院患者面临的一个严重问题。据报道，记录的初始心律和检测到的医疗事件会影响心肺复苏的存活率。本研究旨在确定连续实时心电图（ECG）监测对综合心脏病房中复苏患者预后的影响。
我们使用了2015年2月至2018年12月期间在心血管病房住院且经历过院内心脏骤停并接受心肺复苏的患者的病历进行了这项回顾性研究。被认为有心脏事件高风险（如室性心律失常）的患者将接受连续心电图监测。引入了无线心电图远程监测系统来取代传统的床边心电图监测仪。结局指标为复苏的初始成功率、复苏后24小时生存率和出院生存率。
我们纳入了115例住院期间发生心脏骤停的患者，其中73例（63%）患者接受了无线心电图远程监测。与未监测组相比，接受连续心电图监测的患者复苏初始成功率和复苏后24小时生存率更高（分别为67.1%对40.5%，p = 0.005；49.3%对26.2%，p = 0.015）；但出院生存率无显著差异（21.9%对16.7%，p = 0.498）。在调整协变量后，监测组达到复苏初始成功的可能性更高（优势比[OR]，3.21；95%置信区间[CI]，1.03 - 9.98）。然而，在调整协变量后，监测对24小时生存率和出院生存率的影响接近零。
无线心电图远程监测系统有利于心血管事件高风险且发生院内心脏骤停患者的复苏初始成功；但对24小时生存率和出院生存率的影响较小。
