Hasegawa Daisuke, Sharma Aniket, Dugar Siddharth, Lee Young Im, Sato Ryota
Department of Internal Medicine, Mount Sinai Beth Israel, NY, USA.
Department of Pulmonary and Critical Care Medicine, Mount Sinai Beth Israel, NY, USA.
J Crit Care. 2023 Dec;78:154404. doi: 10.1016/j.jcrc.2023.154404. Epub 2023 Aug 28.
The impact of preceding sepsis on in-hospital cardiac arrest (IHCA)-related mortality has not been established. This study aimed to determine the association between IHCA-related mortality and sepsis.
This retrospective study used the National Inpatient Sample data from 01/2017 to 12/2019. The study included adults (≥18 years) who suffered from IHCA. The study classified cardiac arrest rhythms as ventricular tachycardia/ventricular fibrillation or pulseless electronic activity/asystole. We compared the IHCA-related in-hospital mortality between sepsis and non-sepsis groups in all patients and subgroups divided by cardiac arrest rhythm and age. Multivariable logistic regression analysis was performed to assess the independent association between sepsis and in-hospital mortality.
A total of 357,850 hospitalizations who suffered from IHCA were identified, with sepsis present in 17.6% of patients. IHCA-related in-hospital mortality was 84.8% in sepsis and 68.4% in non-sepsis-related hospitalizations (p < 0.001). IHCA-related in-hospital mortality was higher in sepsis than in non-sepsis groups, regardless of age or cardiac arrest rhythms. In multivariable logistic regression analysis, sepsis was significantly associated with higher mortality with an odds ratio of 2.27 (95% confidence interval: 2.07-2.50, p < 0.001).
Sepsis was associated with higher in-hospital cardiac arrest mortality compared to non-sepsis cases, regardless of age and cardiac rhythm.
先前的脓毒症对院内心脏骤停（IHCA）相关死亡率的影响尚未明确。本研究旨在确定IHCA相关死亡率与脓毒症之间的关联。
这项回顾性研究使用了2017年1月至2019年12月的全国住院患者样本数据。该研究纳入了患有IHCA的成年人（≥18岁）。研究将心脏骤停节律分为室性心动过速/心室颤动或无脉性电活动/心搏停止。我们比较了所有患者以及按心脏骤停节律和年龄划分的亚组中脓毒症组和非脓毒症组之间与IHCA相关的院内死亡率。进行多变量逻辑回归分析以评估脓毒症与院内死亡率之间的独立关联。
共确定了357,850例患有IHCA的住院患者，其中17.6%的患者存在脓毒症。脓毒症患者中与IHCA相关的院内死亡率为84.8%，非脓毒症相关住院患者中为68.4%（p<0.001）。无论年龄或心脏骤停节律如何，脓毒症组中与IHCA相关的院内死亡率均高于非脓毒症组。在多变量逻辑回归分析中，脓毒症与较高的死亡率显著相关，优势比为2.27（95%置信区间：2.07 - 2.50，p<0.001）。
与非脓毒症病例相比，脓毒症与更高的院内心脏骤停死亡率相关，无论年龄和心律如何。
