Szczygiel M, Wright R, Wagner E, Holcomb M S
Ann Emerg Med. 1981 Nov;10(11):566-70. doi: 10.1016/s0196-0644(81)80193-x.
In an attempt to establish prognostic indicators for ultimate long-term survival following advanced life support (ALS), a two-year (1978-79) retrospective study was made of 92 survivors. The survivors were divided into two groups: the first survived admission to the intensive care unit, but subsequently died in the hospital; the second survived to ultimate discharge from the hospital. The groups were compared for sex, age, basic and advanced provider response time, scene an transport time, witnessed versus unwitnessed arrest, traumatic versus medical arrest, type of airway, presence of aspiration, initial cardiac rhythms, post-arrest vital signs, number of defibrillations, post-arrest ECG changes, essential and useful drugs used, and duration of basic and advanced life support. Of all prognostic indicators studied, duration of ALS correlated most closely with ultimate survival. This article advances the definition of ultimate survival of ALS to mean discharge of the patient from the hospital, and advocates this as the most objective evaluation of successful ALS. The article furthermore offers duration of ALS as an effective prognostic indicator of a patient's chance for ultimate survival.
为了确定高级生命支持（ALS）后最终长期生存的预后指标，对92名幸存者进行了一项为期两年（1978 - 1979年）的回顾性研究。幸存者被分为两组：第一组在入住重症监护病房后存活，但随后在医院死亡；第二组存活至最终出院。对两组在性别、年龄、基础和高级急救人员响应时间、现场和转运时间、目击与非目击心脏骤停、创伤性与医疗性心脏骤停、气道类型、有无误吸、初始心律、心脏骤停后生命体征、除颤次数、心脏骤停后心电图变化、使用的基本和有用药物以及基础和高级生命支持持续时间等方面进行了比较。在所有研究的预后指标中，ALS持续时间与最终生存的相关性最为密切。本文将ALS最终生存的定义推进为患者从医院出院，并主张将此作为对成功ALS最客观的评估。此外，本文还提出ALS持续时间作为患者最终生存机会的有效预后指标。
