Shizuoka Graduate University of Public Health, 4-27-2 Kita Ando Aoi-ku, Shizuoka City, 420-0881, Japan.
Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.
BMC Emerg Med. 2022 Jul 6;22(1):120. doi: 10.1186/s12873-022-00676-8.
The risk of choking increases with aging, and the number of cases of choking-induced cardiac arrest is increasing. However, few studies have examined the prognosis of choking-induced cardiac arrest. The aim of this study was to reveal the rates of survival and dependence on devices in the long term after choking-induced cardiac arrest.
We analyzed data from the Shizuoka Kokuho Database, which consists of claims data of approximately 2.2 million people, from April 2012 to September 2018. We selected patients with choking-induced cardiac arrest who received cardiopulmonary resuscitation in the hospital. Patients were excluded if they were less than 20 years old, had an upper airway tumor, received ventilation assistance, or received enteral nutrition in the month prior to cardiac arrest. The primary outcome was death, and the secondary outcomes were the rates of survival at 3-months and independence on devices. Descriptive statistics are presented and compared among age groups (20-64 years, 65-74 years, 75-84 years, 85 years and older), and survival time analysis (Kaplan-Meier method) was performed.
In total, 268 patients were analyzed, including 26 patients in the 20-64 age group, 33 patients in the 65-74 age group, 70 patients in the 75-84 age group, and 139 patients in the ≥85 age group. The overall 3-month survival rate was 5.6% (15/268). The 3-month survival rates were 3.8% (1/26) in the 20-64 age group, 15.2% (5/33) in the 65-74 age group, 8.6% (6/70) in the 75-84 age group, and 2.2% (3/139) in the ≥85 age group. The overall 12-month survival rate was 2.6% (7/268). Of the 7 patients who survived for 12 months, 3 received ventilation management and 5 received tube or intravenous feedings at 3 months. These survivors were still receiving ventilation assistance and tube feedings in the hospital and had not been discharged at 12 months.
The prognosis of choking-induced cardiac arrest was extremely poor when patients were not resuscitated before hospital arrival. Those who survived were mostly dependent on assistive devices. Additionally, none of the survivors dependent on assistive devices had discontinued the use of the devices at the long-term follow-up.
随着年龄的增长，噎食的风险增加，噎食导致心搏骤停的病例数量也在增加。然而，很少有研究探讨噎食导致心搏骤停患者的预后。本研究旨在揭示噎食导致心搏骤停患者长期生存率和对设备的依赖情况。
我们分析了 Shizuoka Kokuho 数据库的数据，该数据库包含了 2012 年 4 月至 2018 年 9 月期间约 220 万人的理赔数据。我们选择了在医院接受心肺复苏的噎食导致心搏骤停患者。排除年龄小于 20 岁、上呼吸道肿瘤、接受通气辅助或在心搏骤停前一个月接受肠内营养的患者。主要结局为死亡，次要结局为 3 个月生存率和对设备的独立情况。描述性统计分析在不同年龄组（20-64 岁、65-74 岁、75-84 岁、85 岁及以上）之间进行比较，并进行生存时间分析（Kaplan-Meier 法）。
共分析了 268 例患者，其中 20-64 岁年龄组 26 例，65-74 岁年龄组 33 例，75-84 岁年龄组 70 例，≥85 岁年龄组 139 例。总体 3 个月生存率为 5.6%（15/268）。20-64 岁年龄组 3 个月生存率为 3.8%（1/26），65-74 岁年龄组为 15.2%（5/33），75-84 岁年龄组为 8.6%（6/70），≥85 岁年龄组为 2.2%（3/139）。总体 12 个月生存率为 2.6%（7/268）。在存活 12 个月的 7 例患者中，3 例接受通气管理，3 例在 3 个月时接受管饲或静脉喂养。这些存活者在 12 个月时仍在接受通气辅助和管饲，尚未出院。
如果患者在到达医院前未进行复苏，噎食导致心搏骤停的预后极差。存活者大多依赖辅助设备。此外，在长期随访中，依赖辅助设备的存活者均未停止使用设备。
