Yang Tengjiao, Tiemuerniyazi Xieraili, Hu Zhan, Feng Wei, Xu Fei
Department of Cardiovascular Surgery, National Center for Cardiovascular Disease and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, 167 Beilishi Road, Xicheng, Beijing, 100037, People's Republic of China.
J Cardiothorac Surg. 2024 Jul 16;19(1):451. doi: 10.1186/s13019-024-02963-w.
Cardiac arrest after coronary artery bypass grafting (CABG) is a serious complication with low survival rate. The prognosis of patients with cardiac arrest in the general ward is worse than that in the intensive care unit (ICU) because of the delayed and poor rescue conditions.
This retrospective study included patients who experienced cardiac arrest after CABG surgery between January 2010 and December 2019 at the Fuwai Hospital. Differences in cardiac arrest between the ICU and the general ward were compared. The patients were divided into shockable and non-shockable rhythm groups, and the differences between the two groups were compared. Finally, we proposed a management protocol for cardiac arrest in the general ward.
We retrospectively analyzed 41,450 patients who underwent CABG only, of whom 231 (0.56%) experienced cardiac arrest post-surgery in the ICU (185/231) or in the general ward (46/231). The rescue success rate and 30-day survival rate of the patients with cardiac arrest in the general ward were 76.1% (35/46) and 58.7% (27/46), respectively. The incidence of the different arrhythmia types of cardiac arrest in the general ward compared with that in the ICU was different (P = 0.010). The 30-day survival rate of the non-shockable rhythm group was 31.8% (7/22), which was worse than that of the shockable rhythm group (83.3% [20/24]; P = 0.001). Kaplan-Meier survival analysis showed that the prognosis of the non-shockable group was poor (P < 0.001).
The incidence of cardiac arrest after CABG was low. The prognosis of patients in the general ward was worse than that of those in the ICU. The proportion of non-shockable rhythm type cardiac arrest was higher in the general ward than in the ICU, and patients in this group had a worse early prognosis.
冠状动脉旁路移植术（CABG）后心脏骤停是一种严重并发症，生存率较低。由于抢救条件延迟且不佳，普通病房心脏骤停患者的预后比重症监护病房（ICU）更差。
这项回顾性研究纳入了2010年1月至2019年12月在阜外医院接受CABG手术后发生心脏骤停的患者。比较了ICU和普通病房心脏骤停情况的差异。将患者分为可电击心律组和不可电击心律组，并比较两组之间的差异。最后，我们提出了普通病房心脏骤停的管理方案。
我们回顾性分析了仅接受CABG手术的41450例患者，其中231例（0.56%）在术后于ICU（185/231）或普通病房（46/231）发生心脏骤停。普通病房心脏骤停患者的抢救成功率和30天生存率分别为76.1%（35/46）和58.7%（27/46）。普通病房与ICU相比，心脏骤停不同心律失常类型的发生率不同（P = 0.010）。不可电击心律组的30天生存率为31.8%（7/22），比可电击心律组（83.3% [20/24]；P = 0.001）更差。Kaplan-Meier生存分析显示，不可电击组的预后较差（P < 0.001）。
CABG后心脏骤停的发生率较低。普通病房患者的预后比ICU患者更差。普通病房不可电击心律型心脏骤停的比例高于ICU，且该组患者的早期预后更差。
