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重症医学科心肺复苏后的死亡率:一项性别特异性结局分析。

Mortality after cardiopulmonary resuscitation on a medical ICU : A sex-specific outcome analysis.

作者信息

Rezar Richard, Wernly Bernhard, Haslinger Michael, Seelmaier Clemens, Schwaiger Philipp, Pretsch Ingrid, Eisl Maria, Jung Christian, Hoppe Uta C, Lichtenauer Michael

机构信息

Clinic of Internal Medicine II, Department of Cardiology, Paracelsus Medical University of Salzburg, 5020, Salzburg, Austria.

Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.

出版信息

Wien Klin Wochenschr. 2021 May;133(9-10):492-499. doi: 10.1007/s00508-021-01831-0. Epub 2021 Mar 9.

Abstract

BACKGROUND

Performing cardiopulmonary resuscitation (CPR) and postresuscitation care in the intensive care unit (ICU) are standardized procedures; however, there is evidence suggesting sex-dependent differences in clinical management and outcome variables after cardiac arrest (CA).

METHODS

A prospective analysis of patients who were hospitalized at a medical ICU after CPR between December 2018 and March 2020 was conducted. Exclusion criteria were age < 18 years, hospital length of stay < 24 h and traumatic CA. The primary study endpoint was mortality after 6 months and the secondary endpoint neurological outcome assessed by cerebral performance category (CPC). Differences between groups were calculated by using U‑tests and χ-tests, for survival analysis both univariate and multivariable Cox regression were fitted.

RESULTS

A total of 106 patients were included and the majority were male (71.7%). No statistically significant difference regarding 6‑month mortality between sexes could be shown (hazard risk, HR 0.68, 95% confidence interval, CI 0.35-1.34; p = 0.27). Neurological outcome was also similar between both groups (CPC 1 88% in both sexes after 6 months; p = 1.000). There were no statistically significant differences regarding general characteristics, pre-existing diseases, as well as the majority of clinical and laboratory parameters or measures performed on the ICU.

CONCLUSION

In a single center CPR database no statistically significant sex-specific differences regarding post-resuscitation care, survival and neurological outcome after 6 months were observed.

摘要

背景

在重症监护病房(ICU)进行心肺复苏(CPR)和复苏后护理是标准化程序;然而,有证据表明心脏骤停(CA)后临床管理和结局变量存在性别差异。

方法

对2018年12月至2020年3月在CPR后入住医疗ICU的患者进行前瞻性分析。排除标准为年龄<18岁、住院时间<24小时和创伤性CA。主要研究终点是6个月后的死亡率,次要终点是通过脑功能分类(CPC)评估的神经学结局。组间差异采用U检验和χ检验计算,生存分析采用单变量和多变量Cox回归。

结果

共纳入106例患者,大多数为男性(71.7%)。两性之间6个月死亡率无统计学显著差异(风险比,HR 0.68,95%置信区间,CI 0.35 - 1.34;p = 0.27)。两组间神经学结局也相似(6个月后两性CPC 1均为88%;p = 1.000)。在一般特征、既往疾病以及在ICU进行的大多数临床和实验室参数或测量方面,无统计学显著差异。

结论

在一个单中心CPR数据库中,未观察到复苏后护理、6个月后的生存率和神经学结局方面存在统计学显著的性别差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8660/8116269/4c6580d0d8ff/508_2021_1831_Fig1_HTML.jpg

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