Wang Mei-Tzu, Huang Wei-Chun, Yen David Hung-Tsang, Yeh En-Hui, Wu Shih-Yuan, Liao Hsun-Hsiang
Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Section of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Front Cardiovasc Med. 2021 Mar 16;8:630102. doi: 10.3389/fcvm.2021.630102. eCollection 2021.
In-hospital cardiac arrest (IHCA) has high mortality rate, which needs more research. This multi-center study aims to evaluate potential risk factors for mortality in patients after IHCA. Data for this study retrospectively enrolled IHCA patients from 14 regional hospitals, two district hospitals, and five medical centers between 2013 June and 2018 December. The study enrolled 5,306 patients and there were 2,871 patients in subgroup of intensive care unit (ICU) and emergency room (ER), and 1,894 patients in subgroup of general wards. As for overall IHCA patients, odds ratio (OR) for mortality was higher in older patients (OR = 1.69; 95% CI:1.33-2.14), those treated with ventilator (OR = 1.79; 95% CI:1.36-2.38) and vasoactive agents (OR = 1.88; 95% CI:1.45-2.46). Whereas, better survival was reported in IHCA patients with initial rhythm as ventricular tachycardia (OR = 0.32; 95% CI: 0.21-0.50) and ventricular fibrillation (OR = 0.26; 95% CI: 0.16-0.42). With regard to ICU and ER subgroup, there was no mortality difference among different nursing shifts, whereas for patients in general wards, overnight shift (OR = 1.83; 95% CI: 1.07-3.11) leads to poor outcome. For IHCA patients, old age, receiving ventilator support and vasoactive agents reported poor survival. Overnight shift had poor survival for IHCA patients in general wards, despite no significance in overall and ICU/ER subgroups.
院内心脏骤停（IHCA）死亡率很高，这需要更多的研究。这项多中心研究旨在评估IHCA患者死亡的潜在风险因素。本研究数据回顾性纳入了2013年6月至2018年12月期间来自14家地区医院、两家区级医院和五个医疗中心的IHCA患者。该研究共纳入5306例患者，其中重症监护病房（ICU）和急诊室（ER）亚组有2871例患者，普通病房亚组有1894例患者。对于总体IHCA患者，老年患者死亡的比值比（OR）更高（OR = 1.69；95%CI：1.33 - 2.14），接受呼吸机治疗的患者（OR = 1.79；95%CI：1.36 - 2.38）以及接受血管活性药物治疗的患者（OR = 1.88；95%CI：1.45 - 2.46）。然而，初始心律为室性心动过速（OR = 0.32；95%CI：0.21 - 0.50）和室颤（OR = 0.26；95%CI：0.16 - 0.42）的IHCA患者生存率更高。对于ICU和ER亚组，不同护理班次之间死亡率无差异，而对于普通病房的患者，夜班（OR = 1.83；95%CI：1.07 - 3.11）导致预后不良。对于IHCA患者，高龄、接受呼吸机支持和血管活性药物治疗的患者生存率较差。尽管在总体和ICU/ER亚组中无显著差异，但普通病房的IHCA患者夜班生存率较差。
