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3
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4
Selection bias, interventions and outcomes for survivors of cardiac arrest.心脏骤停幸存者的选择偏倚、干预措施和结局。
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Cardiac arrests within the emergency department: an Utstein style report, causation and survival factors.急诊科心搏骤停：乌斯太因风格报告、病因和生存因素。
Eur J Emerg Med. 2018 Feb;25(1):12-17. doi: 10.1097/MEJ.0000000000000427.
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Location of In-Hospital Cardiac Arrest in the United States-Variability in Event Rate and Outcomes.美国院内心脏骤停的发生位置——事件发生率及结局的变异性
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Validation of the Pittsburgh Cardiac Arrest Category illness severity score.匹兹堡心脏骤停类别疾病严重程度评分的验证
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Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein Resuscitation Registry Templates for Out-of-Hospital Cardiac Arrest: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation.心脏骤停和心肺复苏结果报告：院外心脏骤停复苏登记模板的更新：急救复苏国际联络委员会（美国心脏协会、欧洲复苏委员会、澳大利亚和新西兰复苏理事会、加拿大心脏和中风基金会、泛美心脏基金会、南非复苏理事会、亚洲复苏理事会）医疗专业人员工作组的声明；以及美国心脏协会紧急心血管护理委员会和心肺、危重病、围手术期和复苏理事会。
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急诊科心脏骤停时基于数据驱动的骤停位置分类

Data-driven classification of arrest location for emergency department cardiac arrests.

作者信息

Mikati Nancy, Callaway Clifton W, Coppler Patrick J, Elmer Jonathan

机构信息

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA.

Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA; Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA; Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, USA.

出版信息

Resuscitation. 2020 Sep;154:26-30. doi: 10.1016/j.resuscitation.2020.07.004. Epub 2020 Jul 13.

DOI:10.1016/j.resuscitation.2020.07.004
PMID:32673732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7484116/
Abstract

BACKGROUND

Resuscitation research is inconsistent in how emergency department (ED) arrests are classified. We tested whether clinical features of ED arrests more closely resembled out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA).

METHODS

We performed a retrospective study including all patients resuscitated from cardiac arrest at a single academic medical center from January 2010 to December 2019. We abstracted clinical information from our prospective registry. We used unsupervised learning (k-prototypes) to identify clusters within the OHCA and IHCA cohorts. We determined the number of subgroups using scree plots. We assigned individual ED arrest patients the nearest OHCA or IHCA cluster based on the shortest Gower distance from that patient to the nearest cluster center. In our secondary analysis, we determined the optimal number of clusters in each of the 3 arrest cohorts, and then calculated the mean Gower distances with the standard deviation (SD) between cluster centers (ED-IHCA, ED-OHCA, IHCA-OHCA).

RESULTS

We included 2723 patients: 372 (14%) ED arrests, 1709 (63%) OHCA, and 642 (23%) IHCA. We identified 3 clusters of OHCA patients, and 4 clusters of IHCA patients. Of ED arrest cases, 292 (78%) most closely resembled an IHCA cluster and 80 (22%) most closely resembled an OHCA cluster. Mean (SD) Gower distance between ED arrest and IHCA centers was 0.33 (0.2). Mean Gower distances between ED arrest-OHCA centers and between IHCA-OHCA centers were 0.41 (0.11).

CONCLUSION

Across multiple aggregated measures, ED arrests resemble IHCA more than OHCA.

摘要

背景

复苏研究在急诊科（ED）心脏骤停的分类方式上并不一致。我们测试了ED心脏骤停的临床特征是否更类似于院外心脏骤停（OHCA）或院内心脏骤停（IHCA）。

方法

我们进行了一项回顾性研究，纳入了2010年1月至2019年12月在一家学术医疗中心从心脏骤停中复苏的所有患者。我们从前瞻性登记处提取了临床信息。我们使用无监督学习（k-原型）来识别OHCA和IHCA队列中的聚类。我们使用碎石图确定亚组的数量。我们根据个体ED心脏骤停患者到最近聚类中心的最短Gower距离，将其分配到最近的OHCA或IHCA聚类中。在我们的二次分析中，我们确定了三个心脏骤停队列中每个队列的最佳聚类数量，然后计算聚类中心之间（ED-IHCA、ED-OHCA、IHCA-OHCA）的平均Gower距离及其标准差（SD）。

结果

我们纳入了2723例患者：372例（14%）为ED心脏骤停，1709例（63%）为OHCA，642例（23%）为IHCA。我们识别出3个OHCA患者聚类和4个IHCA患者聚类。在ED心脏骤停病例中，292例（78%）最类似于IHCA聚类，80例（22%）最类似于OHCA聚类。ED心脏骤停与IHCA中心之间的平均（SD）Gower距离为0.

33（0.2）。ED心脏骤停-OHCA中心之间以及IHCA-OHCA中心之间的平均Gower距离为0.41（0.11）。

结论

通过多种综合测量方法，ED心脏骤停更类似于IHCA而非OHCA。