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心肺复苏持续时间对院外心脏骤停患者神经功能结局的影响。

Impact of cardiopulmonary resuscitation duration on the neurological outcomes of out-of-hospital cardiac arrest.

作者信息

Albinali Hissah, Alumran Arwa, Alrayes Saja

机构信息

Royal Commission Hospital, P.O.Box 11994, Jubail Industrial City, 31961, Saudi Arabia.

Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.

出版信息

Int J Emerg Med. 2022 Mar 19;15(1):12. doi: 10.1186/s12245-022-00418-4.

Abstract

BACKGROUND

Patients experiencing cardiac arrest outside medical facilities are at greater risk of death and might have negative neurological outcomes. Cardiopulmonary resuscitation duration affects neurological outcomes of such patients, which suggests that duration of CPR may be vital to patient outcomes.

OBJECTIVES

The study aims to evaluate the impact of cardiopulmonary resuscitation duration on neurological outcome of patients who have suffered out-of-hospital cardiac arrest.

METHODS

This is a quantitate cross-sectional study where data is collected from emergency cases handled by a secondary hospital in industrial Jubail, Saudi Arabia, between January 2015 and December 2020. There were 257 out-of-hospital cardiac arrest cases, 236 of which resulted in death. The outcome is the survival of OHCA or death, and the neurological outcome by the cerebral performance category (CPC) score for survivors. A score of 1 or 2 defined as good CPC outcome and 3, 4, and 5 as poor outcome.

RESULTS

The mean for the duration of emergency CPR procedures in surviving patients is 26.5 ± 7.20 min, whereas in patients who died after the procedure it is 29.6 ± 9.15 min. Bivariate analysis showed no significant association between duration of CPR and Cerebral Performance Category (CPC) outcome but could be significant if the sample size is large. Age, however, is significantly related to the survivorship of OHCA and to a better CPC outcome. Younger patients are more likely to have better CPC outcome. A good CPC outcome was reported with a limited duration of 8.1 min of CPR, whereas, poor CPC outcomes were associated with prolonged periods of CPR, 13.2 min.

CONCLUSION

Cardiopulmonary Resuscitation Duration out-of-hospital cardiac arrest does not significantly influence the patient neurological outcome in the current study hospital. Variables such as the patient population's uniqueness, underlying medical conditions, or the specific study conditions may explain this variance between the bivariate analysis and the study conclusion. Therefore, a more comprehensive study is recommended in future.

摘要

背景

在医疗机构外发生心脏骤停的患者死亡风险更高,且可能出现不良神经学预后。心肺复苏持续时间会影响此类患者的神经学预后,这表明心肺复苏的持续时间可能对患者的预后至关重要。

目的

本研究旨在评估心肺复苏持续时间对院外心脏骤停患者神经学预后的影响。

方法

这是一项定量横断面研究,收集了沙特阿拉伯朱拜勒市一家二级医院在2015年1月至2020年12月期间处理的急诊病例数据。共有257例院外心脏骤停病例,其中236例导致死亡。结局指标为院外心脏骤停患者的存活或死亡情况,以及存活患者的脑功能分类(CPC)评分所反映的神经学预后。CPC评分为1或2定义为良好的CPC结局,3、4和5定义为不良结局。

结果

存活患者的急诊心肺复苏程序平均持续时间为26.5±7.20分钟,而在心肺复苏后死亡的患者中,该时间为29.6±9.15分钟。双变量分析显示,心肺复苏持续时间与脑功能分类(CPC)结局之间无显著关联,但如果样本量较大可能具有显著性。然而,年龄与院外心脏骤停患者的存活情况以及更好的CPC结局显著相关。年轻患者更有可能获得更好的CPC结局。心肺复苏持续时间限制在8.1分钟时报告有良好的CPC结局,而CPC不良结局与较长时间的心肺复苏(13.2分钟)相关。

结论

在本研究医院中,院外心脏骤停的心肺复苏持续时间对患者神经学预后无显著影响。患者群体的独特性、基础疾病状况或特定的研究条件等变量可能解释了双变量分析与研究结论之间的这种差异。因此,建议未来进行更全面的研究。

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