Goodarzi Afshin, Khodaveisi Masoud, Abdi Alireza, Salimi Rasoul, Oshvandi Khodayar
Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran.
Chronic Diseases (Home Care) Research Center, Department of Community Health Nursing, Hamadan University of Medical Sciences, Hamadan, Iran.
Arch Acad Emerg Med. 2021 Nov 4;9(1):e70. doi: 10.22037/aaem.v9i1.1381. eCollection 2021.
Assessing cardiopulmonary resuscitation (CPR) outcomes of patients with COVID-19 and employing effective strategies for their improvement are essential. This study is designed in this regard.
This cross-sectional study was conducted between January 20, 2020 and January 20, 2021 in the emergency departments of two hospitals in Hamadan and Kermanshah, Iran. Participants were 487 patients with confirmed COVID-19 and cardiac arrest (CA) who had undergone CPR during the study period. Data were collected using the available CPR documentation forms developed based on the Utstein Style and analyses were performed using Chi-square, Fisher's exact, and Mann-Whitney tests and the logistic regression analysis.
Participants' mean age was 69.31±14.73 years and most of them were male (61.8%) and suffered from at least one underlying disease (58.1%). The rate of total and in-hospital CA was 9.67% and 9.39%, respectively. The most prevalent first documented rhythm was asystole (67.9%) and the highest responsivity to CPR was for shockable rhythms. The rate of the return of spontaneous circulation (ROSC) was 9% and the rate of survival to hospital discharge was 2%. The significant predictors of CPR success were age (p = 0.035), epinephrine administration time interval (p = 0.00), CPR duration (p = 0.00), and First documented rhythm (p = 0.009).
The rate of in-hospital CA among studied COVID-19 cases was 9.39% with 9% ROSC and 2% survival to hospital discharge rates after CPR. Primary CPR success among patients with COVID-19 was poor, particularly among those with asystole and bradycardia. It seems that old age and improper doses of epinephrine can reduce CPR success.
评估新型冠状病毒肺炎（COVID-19）患者的心肺复苏（CPR）结果并采用有效的改善策略至关重要。本研究正是为此而设计。
本横断面研究于2020年1月20日至2021年1月20日在伊朗哈马丹和克尔曼沙赫的两家医院急诊科进行。研究对象为487例确诊COVID-19且发生心脏骤停（CA）并在研究期间接受心肺复苏的患者。数据通过基于Utstein模式制定的现有心肺复苏记录表格收集，并使用卡方检验、Fisher精确检验、Mann-Whitney检验和逻辑回归分析进行分析。
参与者的平均年龄为69.31±14.73岁，其中大多数为男性（61.8%），且至少患有一种基础疾病（58.1%）。总心脏骤停率和院内心脏骤停率分别为9.67%和9.39%。首次记录的最常见心律为心搏停止（67.9%），对心肺复苏反应性最高的是可除颤心律。自主循环恢复（ROSC）率为9%，出院生存率为2%。心肺复苏成功的显著预测因素为年龄（p = 0.035）、肾上腺素给药时间间隔（p = 0.00）、心肺复苏持续时间（p = 0.00）和首次记录的心律（p = 0.009）。
在研究的COVID-19病例中，院内心脏骤停率为9.39%，心肺复苏后自主循环恢复率为9%，出院生存率为2%。COVID-19患者的初级心肺复苏成功率较低，尤其是在心搏停止和心动过缓患者中。似乎高龄和肾上腺素剂量不当会降低心肺复苏成功率。
