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儿科院内心肺复苏发生率和存活率趋势:一项韩国基于人群的研究。

Trends in Incidences and Survival Rates in Pediatric In-Hospital Cardiopulmonary Resuscitation: A Korean Population-Based Study.

机构信息

Department of Critical Care Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine Seoul Republic of Korea.

Department of Pediatrics Chungnam National University Hospital Daejeon Republic of Korea.

出版信息

J Am Heart Assoc. 2023 Feb 7;12(3):e028171. doi: 10.1161/JAHA.122.028171. Epub 2023 Jan 25.

Abstract

Background Although the outcome of cardiopulmonary resuscitation (CPR) is still unsatisfactory, there are few studies about temporal trends of in-hospital CPR incidence and mortality. We aimed to evaluate nationwide trends of in-hospital CPR incidence and its associated risk factors and mortality in pediatric patients using a database of the Korean National Health Insurance between 2012 and 2018. Methods and Results We excluded neonates and neonatal intensive care unit admissions. Incidence of in-hospital pediatric CPR was 0.58 per 1000 admissions (3165 CPR/5 429 471 admissions), and the associated mortality was 50.4%. Change in CPR incidence according to year was not significant in an adjusted analysis (=0.234). However, CPR mortality increased significantly by 6.6% every year in an adjusted analysis (<0.001). Hospitals supporting pediatric critical care showed 37.7% lower odds of CPR incidence (<0.001) and 27.5% lower odds of mortality compared with other hospitals in the adjusted analysis (<0.001), and they did not show an increase in mortality ( for trend=0.882). Conclusions Temporal trends of in-hospital CPR mortality worsened in Korea, and the trends differed according to subgroups. Study results highlight the need for ongoing evaluation of CPR trends and for further CPR outcome improvement among hospitalized children.

摘要

背景

尽管心肺复苏(CPR)的结果仍不尽如人意,但关于院内 CPR 发生率和死亡率的时间趋势的研究较少。我们旨在使用韩国国家健康保险数据库,评估 2012 年至 2018 年期间儿科患者的院内 CPR 发生率及其相关危险因素和死亡率的全国趋势。

方法和结果

我们排除了新生儿和新生儿重症监护病房的入院病例。院内儿科 CPR 的发生率为每 1000 次入院 0.58 次(3165 次 CPR/5429471 次入院),相关死亡率为 50.4%。调整分析中,CPR 发生率的变化与年份无关(=0.234)。然而,在调整分析中,CPR 死亡率每年显著增加 6.6%(<0.001)。在调整分析中,与其他医院相比,支持儿科重症监护的医院 CPR 发生率降低了 37.7%(<0.001),死亡率降低了 27.5%(<0.001),并且死亡率没有增加(趋势=0.882)。

结论

韩国院内 CPR 死亡率的时间趋势恶化,且趋势因亚组而异。研究结果强调需要持续评估 CPR 趋势,并进一步改善住院儿童的 CPR 结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b32/9973657/07f0632585a2/JAH3-12-e028171-g001.jpg

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