Xu Yuliu, Hao Jiang, Mei Xiaomin, Zhen Yan
The Second Hospital of Nanjing, Nanjing.
Kardiologiia. 2025 Jun 2;65(5):28-34. doi: 10.18087/cardio.2025.5.n2719.
Analyze the clinical characteristics and resuscitation outcomes of patients with in-hospital cardiac arrest (IHCA) and explore the factors affecting the success rate of cardiopulmonary resuscitation in IHCA patients.
A retrospective observational study was conducted. Patients who received resuscitative treatment for IHCA between September 2022 and December 2023 were evaluated. Clinical data and prognostic information were collected and analyzed, including age, gender, underlying diseases, time of cardiac arrest, cause of cardiac arrest, presence of shockable rhythm, application of defibrillation, duration of CPR (>30 min), presence of endotracheal intubation, cumulative dose of adrenaline, and resuscitation outcomes (return of spontaneous circulation, survival to discharge).
A total of 323 IHCA patients were included in this study. After CPR treatment, 246 had return of spontaneous circulation (ROSC), with 90 surviving to discharge. Coronary artery disease, shockable initial rhythm, presence of a shockable rhythm during resuscitation, defibrillation, and absence of emergency endotracheal intubation differed statistically between the ROSC and non-ROSC groups (univariate analysis, p < 0.001) Age was a statistically significant determinant of whether patients survived to discharge (p < 0.05). Multivariate logistic regression analysis showed that CPR duration ≥ 30 min was an independent risk factor for ROSC, while younger age, application of emergency endotracheal intubation, and lower cumulative dose of adrenaline were independent protective factors for ROSC (p < 0.05).
Age lower than 60 years old, application of defibrillation, and emergency endotracheal intubation are positively associated with increased likelihood of ROSC. Age is an independent risk factor negatively related to survival after discharge. Clinicians should pay close attention to these factors to improve the outcomes of cardiopulmonary resuscitation patients.
分析院内心脏骤停(IHCA)患者的临床特征及复苏结局,探讨影响IHCA患者心肺复苏成功率的因素。
进行一项回顾性观察研究。对2022年9月至2023年12月期间接受IHCA复苏治疗的患者进行评估。收集并分析临床资料和预后信息,包括年龄、性别、基础疾病、心脏骤停时间、心脏骤停原因、可除颤心律的存在情况、除颤的应用、心肺复苏持续时间(>30分钟)、气管插管的存在情况、肾上腺素累积剂量以及复苏结局(自主循环恢复、存活出院)。
本研究共纳入323例IHCA患者。经过心肺复苏治疗后,246例患者实现了自主循环恢复(ROSC),其中90例存活出院。ROSC组和未实现ROSC组在冠状动脉疾病、初始可除颤心律、复苏期间可除颤心律的存在情况、除颤以及未进行紧急气管插管方面存在统计学差异(单因素分析,p<0.001)。年龄是患者能否存活出院的统计学显著决定因素(p<0.05)。多因素逻辑回归分析显示,心肺复苏持续时间≥30分钟是ROSC的独立危险因素,而年龄较小、应用紧急气管插管以及较低的肾上腺素累积剂量是ROSC的独立保护因素(p<0.05)。
年龄低于60岁、应用除颤以及紧急气管插管与ROSC可能性增加呈正相关。年龄是与出院后存活呈负相关的独立危险因素。临床医生应密切关注这些因素,以改善心肺复苏患者的结局。