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中国某三甲医院围手术期心脏骤停的回顾性研究。

Retrospective study of perioperative cardiac arrest from a Chinese tertiary hospital.

机构信息

Department of Anesthesia, Liaocheng People's Hospital, Liaocheng, Shandong, China.

出版信息

Medicine (Baltimore). 2021 Aug 13;100(32):e26890. doi: 10.1097/MD.0000000000026890.

Abstract

Studies on perioperative cardiac arrest in Chinese hospitals have rarely been retrieved from international journals. This survey evaluated the incidence, causes, and outcomes of perioperative cardiac arrests in a Chinese tertiary general hospital between July 2013 and December 2020. The incidence of cardiac arrest within 24 hours of anesthesia administration was retrospectively identified using an anesthesia database in Liaocheng People's Hospital. During the study period, there were 118,152 anesthetics. Data collected included patient characteristics, surgical procedures (elective or emergency), American Society of Anesthesiologists (ASA) physical status score, type of surgery, anesthesia technique, and outcome. Cardiac arrests were grouped into one of 3 groups: totally anesthesia-related, partially anesthesia-related, or anesthesia-unrelated. In total, 41 cardiac arrests (3.5:10,000) and 26 deaths (2.2:10,000) were found. Major risk factors for cardiac arrest were children under 1 year, adults between 19 and 65 years, and the elderly (>80 years) (P < .001), male patients (P = .02), emergency surgery (P < .001), and ASA grade V patients without anesthesia (P = .009). There were 19 anesthesia-related cardiac arrests (1.6:10,000) - 2 were totally related, and 17 were partially related to anesthesia. There were 9 anesthesia-related deaths (0.8:10,000), all of which were partially related to anesthesia. Perioperative cardiac arrests were correlated with age, gender, ASA grade and surgical procedures. The 2 most important patient factors leading to cardiac arrest were hemorrhagic shock from trauma and septic shock, respectively.

摘要

中国医院的围术期心脏骤停研究很少能从国际期刊中检索到。本调查评估了 2013 年 7 月至 2020 年 12 月期间中国一家三级综合医院围术期心脏骤停的发生率、原因和结局。使用聊城市人民医院的麻醉数据库回顾性确定麻醉后 24 小时内心脏骤停的发生率。在研究期间,有 118152 例麻醉。收集的数据包括患者特征、手术程序(择期或急诊)、美国麻醉医师协会(ASA)身体状况评分、手术类型、麻醉技术和结果。心脏骤停分为 3 组之一:完全与麻醉相关、部分与麻醉相关或与麻醉无关。共发现 41 例心脏骤停(3.5:10000)和 26 例死亡(2.2:10000)。心脏骤停的主要危险因素是 1 岁以下儿童、19 至 65 岁成人和 80 岁以上老年人(P < 0.001)、男性患者(P = 0.02)、急诊手术(P < 0.001)和无麻醉的 ASA 5 级患者(P = 0.009)。有 19 例与麻醉相关的心脏骤停(1.6:10000),其中 2 例完全相关,17 例部分与麻醉相关。有 9 例与麻醉相关的死亡(0.8:10000),均与麻醉部分相关。围术期心脏骤停与年龄、性别、ASA 分级和手术程序相关。导致心脏骤停的两个最重要的患者因素分别是创伤性失血性休克和脓毒症性休克。

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