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院内心搏骤停后功能结局:一项回顾性队列研究。

Functional outcomes following an in-hospital cardiac arrest: A retrospective cohort study.

机构信息

School of Rural Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Bendigo, Victoria, Australia; Alfred Health, Melbourne, Victoria, Australia.

Bendigo Health, Bendigo, Victoria, Australia.

出版信息

Aust Crit Care. 2022 Jul;35(4):424-429. doi: 10.1016/j.aucc.2021.07.002. Epub 2021 Aug 26.

Abstract

BACKGROUND/PURPOSE: Whilst much is known about the survival outcomes of patients that suffer an in-hospital cardiac arrest (IHCA) in Australia very little is known about the functional outcomes of survivors. This study aimed to describe the functional outcomes of a cohort of patients that suffered an in-hospital cardiac arrest (IHCA) and survived to hospital discharge in a regional Australian hospital.

METHODS

This is a single-centre retrospective observational cohort study conducted in a regional Australian hospital. All adult patients that had an IHCA in the study hospital between 1 Jan 2017 and 31 Dec 2019 and survived to hospital discharge were included in the study. Functional outcomes were reported using the Modified Rankin Scale (mRS), a six-point scale for which increasing scores represent increasing disability. Scores were assigned through a retrospective review of medical notes.

RESULTS

Overall, 102 adult patients had an IHCA during the study period, of whom 50 survived to hospital discharge. The median age of survivors was 68 years, and a third had a shockable initial arrest rhythm. Of survivors, 47 were able to be assigned both mRS scores. At discharge, 81% of patients achieved a favourable functional outcome (mRS 0-3 or equivalent function at discharge equal to admission).

CONCLUSIONS

Most survivors to hospital discharge following an IHCA have a favourable functional outcome and are discharged home. Although these results are promising, larger studies across multiple hospitals are required to further inform what is known about functional outcomes in Australian IHCA survivors.

摘要

背景/目的:虽然人们对澳大利亚住院期间发生心搏骤停(IHCA)的患者的生存结果了解颇多,但对幸存者的功能结果却知之甚少。本研究旨在描述在澳大利亚一家地区医院住院期间发生心搏骤停(IHCA)并存活至出院的患者队列的功能结果。

方法

这是一项在澳大利亚一家地区医院进行的单中心回顾性观察队列研究。研究医院在 2017 年 1 月 1 日至 2019 年 12 月 31 日期间发生 IHCA 且存活至出院的所有成年患者均纳入研究。通过回顾性审查病历报告功能结果,使用改良 Rankin 量表(mRS),该量表为六分量表,得分越高表示残疾程度越高。

结果

总体而言,在研究期间有 102 名成年患者发生 IHCA,其中 50 名存活至出院。幸存者的中位年龄为 68 岁,三分之一有可除颤的初始心律失常。在幸存者中,有 47 人能够同时分配 mRS 评分。出院时,81%的患者获得了良好的功能结果(mRS 0-3 或出院时的功能相当于入院时)。

结论

大多数 IHCA 存活至出院的患者预后良好,出院后可返回家中。尽管这些结果令人鼓舞,但需要在多家医院开展更大规模的研究,以进一步了解澳大利亚 IHCA 幸存者的功能结果。

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