Department of Emergency Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Department of Emergency Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Australas Emerg Care. 2021 Jun;24(2):84-88. doi: 10.1016/j.auec.2020.08.001. Epub 2020 Aug 23.
There is high variability among clinicians' decision of appropriate cardiopulmonary resuscitation (CPR) duration before deciding for termination of resuscitation. This study attempted to investigate factors associated with the decision to prolong resuscitation attempts in cardiac arrest patients treated in an emergencydepartment (ED).
A retrospective study that evaluated two years of mortality registry starting in 2015 was conducted in the ED of University Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia. Adult out-hospital cardiac arrest (OHCA) patients treated in the ED were included. Multivariate logistic regression analysis was utilized for the exploration of factors associated with prolonged CPR attempts (> 30min).
The median CPR duration was 24min (range 2-68min). Four variables were independently associated with prolonged CPR attempts: younger age (OR, 0.97; 95% CI, 0.95-0.99; p<0.001), pre-existing heart disease (OR, 1.97; 95% CI, 1.07-3.65; p=0.031), occurrence of transient return of spontaneous circulation (ROSC) (OR, 2.38; 95% CI, 1.05-5.36; p=0.037), and access to the ED by nonemergency medical services (EMS) transport (OR, 1.92; 95% CI, 1.09-3.37; p=0.024).
Patient-related and access-related factors were associated with prolonged CPR attempts among OHCA patients resuscitated in the ED.
在决定停止心肺复苏（CPR）之前，临床医生对适当的 CPR 持续时间的决策存在高度变异性。本研究试图探讨与在急诊科（ED）治疗的心脏骤停患者延长复苏尝试相关的因素。
这是一项回顾性研究，评估了从 2015 年开始的两年死亡率登记情况，在马来西亚吉隆坡的马来西亚国民大学医学中心（UKMMC）的 ED 进行。纳入在 ED 治疗的院外心脏骤停（OHCA）成年患者。利用多变量逻辑回归分析探讨与延长 CPR 尝试（>30 分钟）相关的因素。
CPR 持续时间的中位数为 24 分钟（范围 2-68 分钟）。四个变量与延长 CPR 尝试独立相关：年龄较小（OR，0.97；95%CI，0.95-0.99；p<0.001）、预先存在的心脏病（OR，1.97；95%CI，1.07-3.65；p=0.031）、短暂自主循环恢复（ROSC）的发生（OR，2.38；95%CI，1.05-5.36；p=0.037）和通过非紧急医疗服务（EMS）转运到达 ED（OR，1.92；95%CI，1.09-3.37；p=0.024）。
患者相关和获取途径相关因素与 ED 中复苏的 OHCA 患者延长 CPR 尝试有关。
