Department of Anaesthesiology, Erasmus University Medical Centre, Rotterdam, the Netherlands; Department of Intensive Care Medicine, OLVG, Amsterdam, the Netherlands.
Department of Anaesthesiology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Resuscitation. 2021 Oct;167:297-306. doi: 10.1016/j.resuscitation.2021.07.006. Epub 2021 Jul 14.
In-hospital cardiac arrest (IHCA) is an adverse event associated with high mortality. Because of the impact of IHCA more data is needed on incidence, outcomes and associated factors that are present prior to cardiac arrest. The aim was to assess one-year survival, patient-centred outcomes after IHCA and their associated pre-arrest factors.
A multicentre prospective cohort study in 25 hospitals between January 1st 2017 and May 31st 2018. Patients ≥ 18 years receiving cardiopulmonary resuscitation (CPR) for IHCA were included. Data were collected using Utstein and COSCA-criteria, supplemented by pre-arrest Modified Rankin Scale (MRS, functional status) and morbidity through the Charlson Comorbidity Index (CCI). Main outcomes were survival, health-related quality of life (HRQoL, EuroQoL) and functional status (MRS) after one-year.
A total of 713 patients were included, 64.5% was male, median age was 63 years (IQR 52-72) and 72.8% had a non-shockable rhythm, 394 (55.3%) achieved ROSC, 231 (32.4%) survived to hospital discharge and 198 (27.8%) survived one year after cardiac arrest. Higher pre-arrest MRS, age and CCI were associated with mortality. At one year, patients rated HRQoL 72/100 points on the EQ-VAS and 69.7% was functionally independent.
One-year survival after IHCA in this study is 27.8%, which is relatively high compared to previous studies. Survival is associated with a patient's pre-arrest functional status and morbidity. HRQoL appears acceptable, however functional rehabilitation warrants attention. These findings provide a comprehensive insight in in-hospital cardiac arrest prognosis.
院内心搏骤停（IHCA）是一种与高死亡率相关的不良事件。由于 IHCA 的影响，需要更多的数据来了解发病率、结果以及心搏骤停前存在的相关因素。本研究旨在评估 IHCA 后一年的生存率、以患者为中心的结局及其相关的术前因素。
这是一项 2017 年 1 月 1 日至 2018 年 5 月 31 日期间在 25 家医院进行的多中心前瞻性队列研究。纳入接受心肺复苏（CPR）治疗 IHCA 的≥18 岁患者。使用 Utstein 和 COSCA 标准收集数据，并通过术前改良 Rankin 量表（MRS，功能状态）和 Charlson 合并症指数（CCI）补充术前因素。主要结局为一年后的生存率、健康相关生活质量（HRQoL，EuroQoL）和功能状态（MRS）。
共纳入 713 例患者，64.5%为男性，中位年龄为 63 岁（IQR 52-72），72.8%为非可除颤节律，394 例（55.3%）实现了自主循环恢复，231 例（32.4%）存活至出院，198 例（27.8%）存活至心搏骤停后 1 年。术前 MRS、年龄和 CCI 较高与死亡率相关。在 1 年时，患者对 EQ-VAS 的 HRQoL 评分平均为 72/100 分，69.7%的患者功能独立。
本研究中，IHCA 后 1 年的生存率为 27.8%，与以往研究相比相对较高。生存率与患者术前的功能状态和发病前的合并症相关。HRQoL 似乎可以接受，但功能康复仍需要关注。这些发现为院内心搏骤停的预后提供了全面的了解。
