Ashine Taye Mezgebu, Heliso Asnakech Zekiwos, Babore Getachew Ossabo, Ezo Elias, Saliya Sentayehu Admasu, Birehanu Muluneh Bethelhem, Alaro Michael Geletu, Adeba Tadesse Sahle, Sebro Sisay Foga, Hailu Awoke Girma, Abdisa Elias Nigusu
Emergency medicine and Critical Care nursing, College of Medicine and Health Science, Wachemo University, Hosanna, Ethiopia.
Department of Nursing, College of Medicine and Health Science, Wachemo University, Hosanna, Ethiopia.
Patient Relat Outcome Meas. 2024 Feb 15;15:31-43. doi: 10.2147/PROM.S452338. eCollection 2024.
Cardiac arrest (CA) is a common public health problem. Worldwide, cardiac arrest ranks highly among hospitalised patients' public health concerns, particularly in low-income nations. Data on cardiac arrest in intensive care units in low-income countries are relatively scarce. Determining the incidence and predictors of cardiac arrest among ICU patients will be a very crucial and fruitful clinical practice in resource-limited areas like Ethiopia.
A retrospective cohort study was conducted by reviewing charts of 422 systematically selected patients admitted to the ICU from 2018 to 2022 in Wachemo University Comprehensive Specialized Hospital. The extraction tool was used for the data collection, Epi-data version 4.6.0 for data entry, and STATA version 14 for data cleaning and analysis. Kaplan-Meier, log rank test, and life table were used to describe the data. The Cox proportional hazard regression model was used for analysis.
The findings of this study revealed that the overall occurrence of cardiac arrest among critically ill ICU patients was 27% (95% CI: 23, 32). The incidence density rate of cardiac arrest among intensive care unit patients was 19.6 per 1000 person-days of observation. In a multivariable analysis, patients with chronic kidney disease, oxygen saturation <90%, delirium, intubation, and patients admitted to the ICU with cardiovascular disease were found to be independent predictors of cardiac arrest in the Intensive Care Unit.
The incidence density rate of cardiac arrest among intensive care unit patients was high. This study also revealed that chronic kidney disease, delirium, intubation, oxygen saturation level below 90% and patients admitted with cardiovascular disease were independent predictors of the occurrence of cardiac arrest among intensive care unit patients. Finally, we recommend that clinician pays attention to those identified as preventable risk factors for early interventions to improve the recovery process of patients in the ICU.
心脏骤停（CA）是一个常见的公共卫生问题。在全球范围内，心脏骤停在住院患者的公共卫生问题中排名靠前，尤其是在低收入国家。低收入国家重症监护病房（ICU）中心脏骤停的数据相对较少。在像埃塞俄比亚这样资源有限的地区，确定ICU患者心脏骤停的发生率和预测因素将是一项非常关键且富有成效的临床实践。
通过回顾2018年至2022年在瓦切莫大学综合专科医院ICU系统选取的422例患者的病历进行回顾性队列研究。使用提取工具进行数据收集，Epi - data 4.6.0版本进行数据录入，STATA 14版本进行数据清理和分析。采用Kaplan - Meier法、对数秩检验和生命表来描述数据。使用Cox比例风险回归模型进行分析。
本研究结果显示，重症ICU患者中心脏骤停的总体发生率为27%（95%可信区间：23，32）。重症监护病房患者心脏骤停的发病密度率为每1000人日观察期19.6例。在多变量分析中，发现患有慢性肾病、氧饱和度<90%、谵妄、插管以及因心血管疾病入住ICU的患者是ICU中心脏骤停的独立预测因素。
重症监护病房患者心脏骤停的发病密度率较高。本研究还表明，慢性肾病、谵妄、插管、氧饱和度水平低于90%以及因心血管疾病入院的患者是重症监护病房患者心脏骤停发生的独立预测因素。最后，我们建议临床医生关注那些被确定为可预防的风险因素，以便进行早期干预，改善ICU患者的康复过程。
