Tweed W A, Bristow G, Donen N, Kirk B W
Can Med Assoc J. 1980 Feb 9;122(3):301-4.
The resuscitation experience of a large teaching hospital during 1973-77 was reviewed. Resuscitation was attempted on 2091 victims of cardiac arrest; 261 patients (12.5%) survived to be discharged from hospital.Coronary heart disease caused about one half of all the cardiac arrests, but was associated with a better survival rate (14.4%) than the other causes. Cardiac arrest following multiple trauma had the worst prognosis; only 3% of the patients survived to be discharged from hospital. However, the main factor influencing outcome was the site of arrest. The survival rates of patients on whom resuscitation was initiated in the emergency room or an intensive care area were triple and double the rate for patients in hospital wards, although one third of all the cardiac arrests induced by a coronary event and occurring in hospital were on the wards. Patients whose arrest occurred outside hospital, where only basic life support was available, had a survival rate of just 6.3%, whereas those whose arrest occurred in the emergency room had a survival rate of 31.9%. Since these two patient groups were similar in terms of age and diagnosis, we believe that the potential survival rate for victims of cardiac arrest outside of hospital that are optimally treated is close to 30%.These data suggest that increased survival from cardiac arrest can be expected with extension of the resuscitation services both inside and outside of hospital, but particularly with increased emphasis on emergency cardiac care outside of hospital.
回顾了一家大型教学医院在1973 - 1977年期间的复苏经验。对2091例心脏骤停患者进行了复苏尝试；261例患者（12.5%）存活并出院。冠心病导致了约一半的心脏骤停，但与其他病因相比，其存活率更高（14.4%）。多发伤后心脏骤停的预后最差；只有3%的患者存活并出院。然而，影响预后的主要因素是心脏骤停的发生地点。在急诊室或重症监护区开始复苏的患者存活率分别是在医院病房开始复苏患者的三倍和两倍，尽管所有由冠心病事件导致且发生在医院内的心脏骤停中有三分之一发生在病房。在院外发生心脏骤停且仅能获得基本生命支持的患者存活率仅为6.3%，而在急诊室发生心脏骤停的患者存活率为31.9%。由于这两组患者在年龄和诊断方面相似，我们认为院外心脏骤停患者若得到最佳治疗，其潜在存活率接近30%。这些数据表明，通过扩大医院内外的复苏服务，尤其是更加重视院外紧急心脏护理，有望提高心脏骤停患者的存活率。
