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影响心脏骤停患者自主循环恢复的因素。

Factors affecting the return of spontaneous circulation in cardiac arrest patients.

作者信息

Avci Akkan, Yolcu Sadiye, Simsek Yeliz, Yesiloglu Onder, Avci Begum Seyda, Guven Ramazan, Tugcan Mustafa Oğuz, Polat Mustafa, Urfalioglu Ahmet Burak, Gurbuz Mesut, Cinar Hayri, Ozer Ali Ilker, Aksay Erdem, Icme Ferhat

机构信息

Emergency Department, Adana City Research and Training Hospital, Health Science University, Adana, Turkey.

Department of Emergency Medicine, Adana City Research and Training Hospital, Health Science University, Adana, Turkey.

出版信息

Medicine (Baltimore). 2024 Dec 27;103(52):e40966. doi: 10.1097/MD.0000000000040966.

DOI:10.1097/MD.0000000000040966
PMID:39969385
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11688071/
Abstract

The aim of this study was to determine the factors affecting the return of spontaneous circulation (ROSC) in cardiac arrest patients who underwent quality chest compressions as recommended by international guidelines. In this retrospective observational study, the data of nontraumatic out-of-hospital cardiac arrest (OHCA) patients (n = 784) brought by an ambulance to emergency between January 2018 and December 2019 were extracted from the validated hospital automation system. About 452 patients met inclusion criteria. All eligible patients for analysis were treated with an automatic cardiopulmonary resuscitation (CPR) device for chest compression.. Significance threshold for P-value was < 0.05. Logistic regression analysis was used to determine the factors affecting mortality. 61.7% (n = 279) of the study population was male and 65.0% of patients (n = 294) had OHCA. 88 patients (19.5%) had a shockable rhythm and were defibrillated. There was a 0.5-fold increase in mortality rate in patients with thrombocyte count < 199 × 109/L (OR: 0.482, 95% CI: 0.280-0.828) and CPR duration longer than 42 minutes led to a 6.2-fold increase in the probability of ROSC (OR: 6.232, 95% CI: 3.551-10.936) (P < .05). There is no clear consensus on the ideal resuscitation duration; however, our study suggests that it should last at least 42 minutes.

摘要

本研究的目的是确定在按照国际指南建议进行高质量胸外按压的心脏骤停患者中,影响自主循环恢复(ROSC)的因素。在这项回顾性观察研究中,从经过验证的医院自动化系统中提取了2018年1月至2019年12月期间由救护车送往急诊科的非创伤性院外心脏骤停(OHCA)患者(n = 784)的数据。约452例患者符合纳入标准。所有符合分析条件的患者均使用自动心肺复苏(CPR)设备进行胸外按压。P值的显著性阈值为<0.05。采用逻辑回归分析确定影响死亡率的因素。研究人群中61.7%(n = 279)为男性,65.0%的患者(n = 294)发生OHCA。88例患者(19.5%)出现可电击心律并接受了除颤。血小板计数<199×10⁹/L的患者死亡率增加0.5倍(OR:0.482,95%CI:0.280 - 0.828),CPR持续时间超过42分钟导致ROSC概率增加6.2倍(OR:6.232,95%CI:3.551 - 10.936)(P <.05)。关于理想的复苏持续时间尚无明确共识;然而,我们的研究表明其应至少持续42分钟。