Wernberg M, Thomassen A
Acta Anaesthesiol Scand. 1979 Feb;23(1):69-77. doi: 10.1111/j.1399-6576.1979.tb01423.x.
Emergency calls to a total of 1686 patients with verified cardiac arrest in the University Hospital, Arhus, were made in the 8-year period 1969-1977. Among the patients, cardiac arrest occurred outside the hospital in 1347, in the general wards in 240, while it was present on arrival at the emergency room in 99. Resuscitation was attempted in 1172 patients; 181 survived for at least 24 hours, and 72 were discharged alive, including 13 with residual brain damage. The prognosis was best when cardiac arrest occurred in the general wards (13% discharged) and poorest when it occurred outside the hospital (4% discharged). However, in the latter group, the prognosis showed considerable improvement when resuscitation was initiated at once by a doctor or by laymen present at the accident site (16% discharged). As regards the mechanism of cardiac arrest, ventricular fibrillation was found to be a relatively favourable prognostic sign (10% discharged), whereas almost none of the patients with asystole or severe bradycardia survived. The possibility of improving the prognosis of cardiac arrest occurring outside hospital by the establishment of mobile coronary care units and by instructing lay people in the technique of cardiopulmonary resuscitation is discussed.
1969年至1977年的8年间，奥胡斯大学医院共接到1686例确诊心脏骤停患者的急救电话。其中，1347例患者的心脏骤停发生在院外，240例发生在普通病房，99例在抵达急诊室时就已出现心脏骤停。1172例患者尝试进行了复苏；181例存活至少24小时，72例存活出院，其中13例有残留脑损伤。心脏骤停发生在普通病房时预后最佳（13%出院），发生在院外时预后最差（4%出院）。然而，在后一组中，如果由医生或事故现场的外行人立即进行复苏，预后有显著改善（16%出院）。关于心脏骤停的机制，发现室颤是相对较好的预后体征（10%出院），而几乎没有心脏停搏或严重心动过缓的患者存活。文中讨论了通过建立流动冠心病监护病房以及指导外行人掌握心肺复苏技术来改善院外心脏骤停预后的可能性。
