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患有和未患有新型冠状病毒肺炎(COVID-19)的患者院内心脏骤停的临床特征及结局

Clinical characteristics and outcomes of in-hospital cardiac arrest among patients with and without COVID-19.

作者信息

Yuriditsky Eugene, Mitchell Oscar J L, Brosnahan Shari B, Smilowitz Nathaniel R, Drus Karsten W, Gonzales Anelly M, Xia Yuhe, Parnia Sam, Horowitz James M

机构信息

Division of Cardiology, Department of Medicine, NYU Langone Medical Center, 550 First Ave, New York, NY 10016, United States.

Division of Pulmonary, Allergy and Critical Care and the Center for Resuscitation Science, Department of Medicine, Hospital of the University of Pennsylvania, 3400 Spruce St. Philadelphia, PA 19104, United States.

出版信息

Resusc Plus. 2020 Dec;4:100054. doi: 10.1016/j.resplu.2020.100054. Epub 2020 Nov 21.

Abstract

AIMS

To define outcomes of patients with COVID-19 compared to patients without COVID-19 suffering in-hospital cardiac arrest (IHCA).

MATERIALS AND METHODS

We performed a single-center retrospective study of IHCA cases. Patients with COVID-19 were compared to consecutive patients without COVID-19 from the prior year. Return of spontaneous circulation (ROSC), 30-day survival, and cerebral performance category (CPC) at 30-days were assessed.

RESULTS

Fifty-five patients with COVID-19 suffering IHCA were identified and compared to 55 consecutive IHCA patients in 2019. The COVID-19 cohort was more likely to require vasoactive agents (67.3% v 32.7%, p = 0.001), invasive mechanical ventilation (76.4% v 23.6%, p < 0.001), renal replacement therapy (18.2% v 3.6%, p = 0.029) and intensive care unit care (83.6% v 50.9%, p = 0.001) prior to IHCA. Patients with COVID-19 had shorter CPR duration (10 min v 22 min, p = 0.002). ROSC (38.2% v 49.1%, p = 0.336) and 30-day survival (20% v 32.7%, p = 0.194) did not differ. A 30-day cerebral performance category of 1 or 2 was more common among non-COVID patients (27.3% v 9.1%, p = 0.048).

CONCLUSIONS

Return of spontaneous circulation and 30-day survival were similar between IHCA patients with and without COVID-19. Compared to previously published data, we report greater ROSC and 30-day survival after IHCA in COVID-19.

摘要

目的

确定与未感染新冠病毒但在医院发生心脏骤停(IHCA)的患者相比,感染新冠病毒的患者的预后情况。

材料与方法

我们对IHCA病例进行了一项单中心回顾性研究。将感染新冠病毒的患者与上一年连续的未感染新冠病毒的患者进行比较。评估自主循环恢复(ROSC)、30天生存率以及30天时的脑功能分类(CPC)。

结果

确定了55例感染新冠病毒且发生IHCA的患者,并与2019年连续的55例IHCA患者进行比较。新冠病毒感染队列在发生IHCA之前更有可能需要血管活性药物(67.3%对32.7%,p = 0.001)、有创机械通气(76.4%对23.6%,p < 0.001)、肾脏替代治疗(18.2%对3.6%,p = 0.029)以及重症监护病房护理(83.6%对50.9%,p = 0.001)。感染新冠病毒的患者心肺复苏持续时间较短(10分钟对22分钟,p = 0.002)。ROSC(38.2%对49.1%,p = 0.336)和30天生存率(20%对32.7%,p = 0.194)没有差异。在非新冠患者中,30天时脑功能分类为1或2更为常见(27.3%对9.1%,p = 0.048)。

结论

感染新冠病毒和未感染新冠病毒的IHCA患者的自主循环恢复和30天生存率相似。与之前发表的数据相比,我们报告新冠病毒感染患者发生IHCA后的ROSC和30天生存率更高。

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