Schwaiger Daniel, Krösbacher Armin, Eckhardt Christine, Schausberger Lukas, Baubin Michael, Rajsic Sasa
Medical University of Innsbruck, Department of Anaesthesiology and Intensive Care Medicine, Austria.
Medical University of Innsbruck, Department of Anaesthesiology and Intensive Care Medicine, Austria.
Heart Lung. 2025 Sep-Oct;73:1-8. doi: 10.1016/j.hrtlng.2025.04.003. Epub 2025 Apr 18.
Background Out-of-hospital cardiac arrest (OHCA) is a major public health issue with low survival rates. Objective Identification of predictors for survival and good neurological outcomes following OHCA. Methods This retrospective study included all OHCA patients between January 2014 and December 2023. Data was collected from the local resuscitation registry and hospital electronic medical records. Neurological outcomes were measured using the Cerebral Performance Category (CPC) scale. Results At hospital admission return of spontaneous circulation (ROSC) was achieved in 36 % of cases (411/1128), with overall survival rates of 29 % (328/1128) at 24 h and 16 % (178/1128) at 30 days, respectively. Good neurological outcomes (CPC 1 and 2) were observed in 13 % (144/1128) of patients. The main suspected cause of cardiac arrest was cardiac origin (54 %, 608/1128), followed by hypoxia (11 %, 127/1128). Survivors were significantly younger (60 vs 71 years, p < 0.001), were less disabled (p < 0.001), had a higher incidence of witnessed cardiac arrest (80 % vs 69 %, p = 0.018), received more often bystander cardiopulmonary resuscitation (CPR, 62 % vs 47 %, p = 0.003) or Dispatcher Assisted-CPR (44 % vs 32 %, p = 0.004). Moreover, patients who survived at least 30 days had a higher incidence of shockable initial rhythm (57 % vs 24 %, p < 0.001). Conclusions Patients who survived at least 30 days were younger and male, had less disability, a shockable initial rhythm, and a cardiac arrest in public.
院外心脏骤停（OHCA）是一个生存率较低的重大公共卫生问题。目的：确定OHCA后生存及良好神经功能结局的预测因素。方法：这项回顾性研究纳入了2014年1月至2023年12月期间所有的OHCA患者。数据收集自当地复苏登记册和医院电子病历。使用脑功能分类（CPC）量表评估神经功能结局。结果：入院时36%（411/1128）的病例实现了自主循环恢复（ROSC），24小时总体生存率为29%（328/1128），30天时为16%（178/1128）。13%（144/1128）的患者观察到良好的神经功能结局（CPC 1和2）。心脏骤停的主要疑似原因是心脏源性（54%，608/1128），其次是缺氧（11%，127/1128）。幸存者明显更年轻（60岁对71岁，p<0.001），残疾程度更低（p<0.001），目击心脏骤停的发生率更高（80%对69%，p = 0.018），更常接受旁观者心肺复苏（CPR，62%对47%，p = 0.003）或调度员辅助CPR（44%对32%，p = 0.004）。此外，至少存活30天的患者可电击初始心律的发生率更高（57%对24%，p<0.001）。结论：至少存活30天的患者更年轻、为男性，残疾程度更低，有可电击的初始心律，且在公共场合发生心脏骤停。
