Nam In Chul, Lee Esther Sangeun, Shin Ji Hoon, Li Vincent Xinrui, Chu Hee Ho, Park Sung Eun, Won Jung Ho
Department of Radiology, Gyeongsang National University College of Medicine, Gyeongsang National University Changwon Hospital, Changwon 51472, Korea.
Harvard College, Harvard University, Cambridge, MA 02138, USA.
J Clin Med. 2022 Jan 20;11(3):511. doi: 10.3390/jcm11030511.
An intervention radiology (IR) unit collected cardiac arrest data between January 2014 and July 2020. Of 344,600 procedures, there were 23 cardiac arrest patients (0.0067%). The patient data was compared to a representative sample (N = 400) of the IR unit to evaluate the incidence and factors associated with cardiac arrest during IR procedures. Age, procedure urgency, American Society of Anesthesiologists (ASA) physical status, procedure type, and underlying medical conditions were identified as valuable predictors of a patient's susceptibility to cardiac arrest during an IR procedure. The proportion of pediatrics was higher for cardiac arrest patients, and most required immediate procedures. The distribution of high ASA physical status (III or greater) was skewed compared to that of the non-cardiac arrest patients. Vascular procedures were associated with higher risk than non-vascular procedures. The patients who underwent non-transarterial chemoembolization arterial procedures demonstrated relative risks of 4.4 and 11.7 for cardiac arrest compared to biliary procedures and percutaneous catheter drainage, respectively. In addition, the six patients (26.1%) who died before discharge all underwent vascular procedures. Relative to patients with acute kidney injury, patients with malignancy, hypertension, and diabetes mellitus demonstrated relative risks of 3.3, 3.4, and 4.8 for cardiac arrest, respectively.
一个介入放射学(IR)科室收集了2014年1月至2020年7月期间的心脏骤停数据。在344,600例手术中,有23例心脏骤停患者(0.0067%)。将患者数据与该IR科室的一个代表性样本(N = 400)进行比较,以评估IR手术期间心脏骤停的发生率及相关因素。年龄、手术紧急程度、美国麻醉医师协会(ASA)身体状况、手术类型和基础疾病被确定为患者在IR手术期间易发生心脏骤停的重要预测因素。心脏骤停患者中儿科患者的比例较高,且大多数需要急诊手术。与非心脏骤停患者相比,高ASA身体状况(III级或更高)的分布存在偏差。血管手术的风险高于非血管手术。与胆道手术和经皮导管引流相比,接受非经动脉化疗栓塞动脉手术的患者发生心脏骤停的相对风险分别为4.4和11.7。此外,6例(26.1%)在出院前死亡的患者均接受了血管手术。相对于急性肾损伤患者,恶性肿瘤、高血压和糖尿病患者发生心脏骤停的相对风险分别为3.3、3.4和4.8。