Shibahashi Keita, Inoue Ken, Kato Taichi, Sugiyama Kazuhiro
Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130-8575, Japan.
Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130-8575, Japan.
Resuscitation. 2024 Dec;205:110448. doi: 10.1016/j.resuscitation.2024.110448. Epub 2024 Nov 30.
To investigate the characteristics, outcomes, and prognostic factors of patients with hanging-induced out-of-hospital cardiac arrest (OHCA).
We analysed data from a population-based Japanese nationwide OHCA registry (2021-2022), comparing patients aged ≥18 years with hanging-induced OHCA to those with other OHCA causes. The primary outcome was 1-month favourable neurological outcomes. Prognostic factors for hanging-induced OHCA were identified using multivariable logistic regression analysis.
Of 263,426 OHCAs, 7,878 (3.0 %) were hanging-induced, with an incidence of 3.1 per 100,000 person-years. Patients with hanging-induced OHCA were younger (median age; 58 vs. 81 years), more frequently males (60.2 % vs. 57.5 %), and less likely to have a witness (1.7 % vs. 42.1 %) and initial shockable rhythm (0.4 % vs. 5.9 %). The chance of 1-month favourable neurological outcomes was significantly lower in patients with hanging-induced OHCA than those with other OHCA causes (0.4 % vs. 2.5 %). Factors associated with favourable neurological outcomes included younger age, witnessed arrest, initial non-asystole cardiac rhythm, and prehospital return of spontaneous circulation (ROSC). Patients with initial non-asystole rhythm and prehospital ROSC had an 11.1 % probability of favourable neurological outcomes, whereas 97.1 % of patients lacking these characteristics had only a 0.1 % probability.
Prognosis following hanging-induced OHCAs was significantly worse compared to OHCAs of other causes. While some patients with initial non-asystole rhythm and prehospital ROSC may benefit from cardiopulmonary resuscitation, most lack these favourable features and have an exceedingly low chance of achieving favourable neurological outcomes at 1-month post-arrest.
探讨上吊所致院外心脏骤停（OHCA）患者的特征、结局及预后因素。
我们分析了基于日本全国人口的OHCA登记系统（2021 - 2022年）的数据，将年龄≥18岁的上吊所致OHCA患者与其他原因导致OHCA的患者进行比较。主要结局为1个月时良好的神经功能结局。使用多变量逻辑回归分析确定上吊所致OHCA的预后因素。
在263,426例OHCA患者中，7878例（3.0%）是由上吊所致，发病率为每10万人年3.1例。上吊所致OHCA患者更年轻（中位年龄：58岁对81岁），男性比例更高（60.2%对57.5%），有目击者的可能性更小（1.7%对42.1%），初始可电击心律的可能性更小（0.4%对5.9%）。上吊所致OHCA患者1个月时获得良好神经功能结局的几率显著低于其他原因导致OHCA的患者（0.4%对2.5%）。与良好神经功能结局相关的因素包括年龄较小、有目击者的心脏骤停、初始非心搏停止心律以及院前自主循环恢复（ROSC）。初始非心搏停止心律且院前有ROSC的患者有11.1%的几率获得良好神经功能结局，而缺乏这些特征的患者中97.1%仅有0.1%的几率。
与其他原因导致的OHCA相比，上吊所致OHCA后的预后明显更差。虽然一些初始非心搏停止心律且院前有ROSC的患者可能从心肺复苏中获益，但大多数患者缺乏这些有利特征，在心脏骤停后1个月获得良好神经功能结局的几率极低。
