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评估影响院外心脏骤停(OHCA)复苏成功结局的关键因素。

Assessing Key Factors Influencing Successful Resuscitation Outcomes in Out-of-Hospital Cardiac Arrest (OHCA).

作者信息

Ichim Cristian, Pavel Vlad, Mester Patricia, Schmid Stephan, Todor Samuel Bogdan, Stoia Oana, Anderco Paula, Kandulski Arne, Müller Martina, Heumann Philipp, Boicean Adrian

机构信息

Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania.

Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, 93053 Regensburg, Germany.

出版信息

J Clin Med. 2024 Dec 4;13(23):7399. doi: 10.3390/jcm13237399.

Abstract

Out-of-hospital cardiac arrest (OHCA) is a critical health issue with survival influenced by multiple factors. This study analyzed resuscitation outcomes at the County Clinical Emergency Hospital of Sibiu, Romania, during pre-COVID-19 and pandemic periods. A retrospective analysis of 508 OHCA patients (2017-2020) assessed the return of spontaneous circulation (ROSC) as the primary endpoint. Statistical methods included decision tree analysis, logistic regression and ROC curve analysis to evaluate the predictive value of adrenaline dose and patient factors. The mortality rate was 68.7%, with non-shockable rhythms predominant among fatalities. Rural patients, though younger, had lower ROSC rates than urban counterparts. Logistic regression showed that lower adrenaline doses (≤4 mg, OR 11.835 [95% CI: 6.726-20.27]; 4-6 mg, OR 2.990 [95% CI: 1.773-5.042]) were associated with better ROSC outcomes. : A multivariable model (AUC = 0.773) incorporating demographics and pandemic status outperformed adrenaline dose alone (AUC = 0.711).

摘要

院外心脏骤停(OHCA)是一个关键的健康问题,其生存率受多种因素影响。本研究分析了罗马尼亚锡比乌县临床急救医院在新冠疫情前和疫情期间的复苏结果。对508例OHCA患者(2017 - 2020年)进行回顾性分析,将自主循环恢复(ROSC)作为主要终点。统计方法包括决策树分析、逻辑回归和ROC曲线分析,以评估肾上腺素剂量和患者因素的预测价值。死亡率为68.7%,死亡者中非可电击心律占主导。农村患者尽管较年轻,但ROSC率低于城市患者。逻辑回归显示,较低的肾上腺素剂量(≤4 mg,OR 11.835 [95% CI:6.726 - 20.27];4 - 6 mg,OR 2.990 [95% CI:1.773 - 5.042])与更好的ROSC结果相关。:一个纳入人口统计学和疫情状态的多变量模型(AUC = 0.773)比单独使用肾上腺素剂量(AUC = 0.711)表现更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/932f/11642300/2ccf17d1b447/jcm-13-07399-g001.jpg

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