Bedell S E, Delbanco T L, Cook E F, Epstein F H
N Engl J Med. 1983 Sep 8;309(10):569-76. doi: 10.1056/NEJM198309083091001.
Little is known about prognostic factors that determine outcomes after in-hospital cardiopulmonary resuscitation. We studied prospectively 294 consecutive patients who were resuscitated in a university teaching hospital. Forty-one patients (14 per cent) were discharged from the hospital; three quarters of them were still alive six months later. A multivariate analysis revealed that pneumonia, hypotension, renal failure, cancer, and a homebound life style before hospitalization were significantly associated with in-hospital mortality (P less than 0.05). None of the 58 patients with pneumonia and none of the 179 in whom resuscitation took longer than 30 minutes survived to be discharged. On the other hand, fully 42 per cent of the patients who survived for 24 hours after resuscitation left the hospital. At the time of discharge from the hospital and again six months later, 93 per cent of the survivors were mentally intact. Although depression was generally present at the time of discharge, it tended to resolve subsequently. However, all patients reported some decrease in functional capacity, often attributed to fear. This persisted at six months after discharge. Age alone did not appear to influence the prognosis for survival after cardiopulmonary resuscitation or the adjustment to chronic illness after discharge from the hospital.
关于决定院内心肺复苏后预后的因素，目前所知甚少。我们对一所大学教学医院中连续接受复苏的294例患者进行了前瞻性研究。41例患者（14%）出院；其中四分之三在6个月后仍存活。多因素分析显示，肺炎、低血压、肾衰竭、癌症以及住院前居家的生活方式与院内死亡率显著相关（P<0.05）。58例肺炎患者和179例复苏时间超过30分钟的患者中无一例存活出院。另一方面，复苏后存活24小时的患者中有42%出院。出院时以及6个月后，93%的幸存者精神状态完好。尽管出院时普遍存在抑郁情绪，但随后往往会缓解。然而，所有患者均报告功能能力有所下降，这通常归因于恐惧。出院6个月后这种情况仍然存在。单独的年龄似乎并不影响心肺复苏后的生存预后或出院后对慢性病的适应情况。
