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院内心脏骤停患者心肺复苏持续时间对功能转归、独立水平及生存的影响:一项前瞻性研究。

Impact of cardiopulmonary resuscitation duration on functional outcome, level of independence, and survival among patients with in-hospital cardiac arrests: A pilot study.

作者信息

Amirtharaj Anandhi D, Suresh Malarvizhi, Murugesan Navaneetha, Kurien Mony, Karnam Ali H F

机构信息

College of Nursing, Sultan Qaboos University, Sultanate of Oman.

Medical Surgical Nursing, College Of Nursing, P.I.M.S, Kanagachettikulam, Pondicherry, India.

出版信息

J Educ Health Promot. 2024 Aug 29;13:310. doi: 10.4103/jehp.jehp_1711_23. eCollection 2024.

Abstract

BACKGROUND

Cardiovascular diseases (CVDs) are the leading cause of cardiac arrest (CA), which are presented as sudden cardiac arrest (SCA) and sudden cardiac death (SCD). To assess the impact of CPR duration on the functional outcome, level of independence, and survival among patients with in-hospital cardiac arrest (IHCA).

MATERIAL AND METHODS

This prospective longitudinal pilot study was conducted at a tertiary care hospital in South India. Data were collected using consecutive sampling techniques from nine patients with IHCA, and outcomes were measured using the cerebral performance category (CPC) and Katz level of independence (LOI) during the immediate post-CPR, 30 day, and 90 day. Based on the principles of pilot study design, descriptive statistics was used to analyze the results. Inferential statistics analysis was not applicable based on the sample size of the pilot study.

RESULTS

Nine patients were included in this pilot study. The mean and median age of the patients were 48.11 ± 8.66 (46, IQR, 32-67 years) and 77.8% were male patients. The primary medical diagnosis was cardiology and neurology conditions among 44.4% and 22.2% of patients. The mean and median CPR duration was 12.11 ± 4.59 minutes (IQR, 8-15.50) and 44.4% achieved a return of spontaneous circulation (ROSC) with a mean ROSC time of 5.56 ± 7.418. The mean CPC score in the immediate post-CPR period and 30 day was 4 ± 1.732 and 4.56 ± 1.33, with mortality of 66.7% and 33.3% survivors in the immediate post-CPR period. While the mean LOI score among the survivors during the immediate post-CPR and 30 day was zero and four. which highlights the complete dependency of patients during the immediate post-CPR with significant improvement by the 30 day and unchanged until the 90 day.

CONCLUSIONS

The overall mortality and survival were 88.8% and 11.1%, respectively, by the 90 day. The pilot study is feasible at the end of the study. However, due to the difficulty in obtaining CA, an additional tertiary hospital was included in the larger study.

摘要

背景

心血管疾病(CVDs)是心脏骤停(CA)的主要原因,表现为心搏骤停(SCA)和心源性猝死(SCD)。旨在评估心肺复苏(CPR)持续时间对院内心脏骤停(IHCA)患者功能结局、独立水平和生存率的影响。

材料与方法

这项前瞻性纵向试点研究在印度南部的一家三级护理医院进行。采用连续抽样技术收集了9例IHCA患者的数据,并在心肺复苏后即刻、30天和90天时使用脑功能分类(CPC)和卡茨独立水平(LOI)来测量结局。基于试点研究设计的原则,使用描述性统计分析结果。根据试点研究的样本量,不适用推断性统计分析。

结果

9例患者纳入本试点研究。患者的平均年龄和中位数年龄分别为48.11±8.66岁(46岁,四分位距,32 - 67岁),男性患者占77.8%。44.4%和22.2%的患者主要医学诊断为心脏病和神经病学疾病。CPR平均持续时间和中位数持续时间分别为12.11±4.59分钟(四分位距,8 - 15.50),44.4%的患者实现自主循环恢复(ROSC),平均ROSC时间为5.56±7.418。心肺复苏后即刻和30天时的平均CPC评分为4±1.732和4.56±1.33,心肺复苏后即刻的死亡率为66.7%,幸存者为33.3%。而幸存者在心肺复苏后即刻和30天时的平均LOI评分为零和四分。这突出了患者在心肺复苏后即刻完全依赖他人,到30天时显著改善,直到90天保持不变。

结论

到90天时,总体死亡率和生存率分别为88.8%和11.1%。在研究结束时,试点研究是可行的。然而,由于获取心脏骤停患者存在困难,在更大规模的研究中纳入了另一家三级医院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/442c/11488772/b03298fd8bdb/JEHP-13-310-g001.jpg

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