院外心脏骤停（OHCA）患者的死亡率预测因素：来自阿曼苏丹国的一项回顾性横断面研究。
Predictors of Mortality in Out-of-hospital Cardiac Arrest (OHCA) Patients: A Retrospective Cross-sectional Study from the Sultanate of Oman.
作者信息
Al-Habsi Tasnim, Al-Mandhari Amal, Hazra Darpanarayan, Al-Badri Mohammed, Al Harthi Khalid, Al-Obaidani Thekra, Al-Hinai Maimoona, Al-Shukaili Abdul M, Al-Hsani Mohammed, Al Hinai Naima
机构信息
Medical Student, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman.
Department of Emergency Medicine, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman.
出版信息
Indian J Crit Care Med. 2024 Nov;28(11):1056-1062. doi: 10.5005/jp-journals-10071-24824. Epub 2024 Oct 30.
BACKGROUND
Out-of-hospital cardiac arrest (OHCA) is a significant global health challenge with high incidence and low survival rates; this study aimed to predict mortality in these patients.
METHODS
This 5-year retrospective chart review, conducted at the emergency departments (EDs) of two tertiary hospitals, systematically categorized, coded, and analyzed variables to assess mortality risk in OHCA patients.
RESULTS
Of the 822 (36.5%) patients who met the inclusion criteria, the mean age was 60.2 years (SD ± 17.6), with 65.7% being male. Cardiopulmonary resuscitation (CPR) was attempted on 586 patients, with 178 (30.4%) achieving return of spontaneous circulation (ROSC) in the ED. Significant risk factors for mortality included hypertension ( = 0.01), diabetes mellitus ( = 0.05), respiratory illnesses ( = 0.04), and having three or more comorbidities ( = 0.01). Manifestations in previous ED visits (<180 days), such as cardiac complaints ( = 0.05) and dyspnea due to fluid overload ( = 0.02), were significant. Among the cohort, 76.4% visited the ED (<180 days) and had a mortality rate of 95.7%, compared to 78.4% for those who did not visit. Asystole and pulseless electrical activity (PEA) were significant factors for the nonachievement of ROSC ( < 0.001 vs = 0.032) and mortality ( < 0.001 vs = 0.03). Overall, 49 patients (8.4%) survived to hospital discharge.
CONCLUSION
Elderly males with hypertension, diabetes, respiratory ailments, and multiple comorbidities constituted a significant risk group. Factors such as prior episodes of chest pain and fluid overload were associated with higher mortality. Patients with asystole and PEA had low survival rates.
HOW TO CITE THIS ARTICLE
Al-Habsi T, Al-Mandhari A, Hazra D, Al-Badri M, Al Harthi K, Al-Obaidani T, Predictors of Mortality in Out-of-hospital Cardiac Arrest (OHCA) Patients: A Retrospective Cross-sectional Study from the Sultanate of Oman. Indian J Crit Care Med 2024;28(11):1056-1062.
背景
院外心脏骤停（OHCA）是一项重大的全球健康挑战，发病率高且生存率低；本研究旨在预测这些患者的死亡率。
方法
在两家三级医院的急诊科进行了这项为期5年的回顾性病历审查，系统地对变量进行分类、编码和分析，以评估OHCA患者的死亡风险。
结果
在符合纳入标准的822名（36.5%）患者中，平均年龄为60.2岁（标准差±17.6），男性占65.7%。对586名患者进行了心肺复苏（CPR），其中178名（30.4%）在急诊科实现了自主循环恢复（ROSC）。死亡的显著危险因素包括高血压（P = 0.01）、糖尿病（P = 0.05）、呼吸系统疾病（P = 0.04）以及患有三种或更多合并症（P = 0.01）。之前在急诊科就诊（<180天）时的表现，如心脏不适（P = 0.05）和因液体过载导致的呼吸困难（P = 0.02），具有显著性。在该队列中，76.4%的患者在（<180天）内就诊，死亡率为95.7%，而未就诊者的死亡率为78.4%。心脏停搏和无脉电活动（PEA）是未实现ROSC（P < 0.001 vs P = 0.032）和死亡（P < 0.001 vs P = 0.03）的显著因素。总体而言，49名患者（8.4%）存活至出院。
结论
患有高血压、糖尿病、呼吸系统疾病和多种合并症的老年男性构成了一个显著的风险群体。如先前胸痛发作和液体过载等因素与较高的死亡率相关。心脏停搏和PEA患者的生存率较低。
如何引用本文
Al-Habsi T, Al-Mandhari A, Hazra D, Al-Badri M, Al Harthi K, Al-Obaidani T, 院外心脏骤停（OHCA）患者死亡率的预测因素：阿曼苏丹国的一项回顾性横断面研究。《印度重症监护医学杂志》2024；28(11):1056 - 1062。
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