Hofgärtner F, Messelken M, Stebich M, Milewski P, Sigel H
1. Medizinische Klinik, Klinik am Eichert, Göppingen.
Dtsch Med Wochenschr. 1995 Sep 22;120(38):1267-72. doi: 10.1055/s-2008-1055474.
The factors that influence long-term survival after out-of-hospital resuscitations were investigated.
Between 1985 and 1989, out of a total of 8403 responded emergency calls, 505 resuscitations were undertaken out of hospital by the emergency medical service in Göppingen. All emergency calls were recorded uniformly. Of the 505 resuscitations, 154 were primarily successful (30.5%), and 58 were secondarily successful, i.e. the patients were ultimately discharged from hospital. In 56 of them the further course could be followed at least 5 years after the resuscitation (45 males, 11 females; mean age 57 [10-83] years). The patients' charts were analysed; in 51 cases data could be obtained from the family doctor, from ambulant care or from home visits.
34 patients (60.4%) were still alive 5 years after the resuscitation. The highest death rate (16%) was in the first post-resuscitation year. Prognostically unfavourable factors were: advanced age (P < 0.01), underlying cardiac disease (n = 49; P < 0.025), especially coronary heart disease (n = 34; P < 0.01). Patients with primary ventricular fibrillation and previous myocardial infarction (n = 10) had a poorer prognosis than those with acute infarction (n = 24; P < 0.05). Reduced survival chances occurred in those with impaired left ventricular function, as measured echocardiographically (P < 0.05), or with cardiac arrhythmias, Lown classes III and IV (P < 0.05), as well as in those with severe neurological sequelae (n = 8; P < 0.08).
Long-term prognosis depends, in the first instance, on the resuscitated patient's basic condition and not so much on the circumstances of the resuscitation.
研究院外复苏后影响长期生存的因素。
1985年至1989年间，在总共8403次应答的急救呼叫中，哥廷根的紧急医疗服务机构在院外进行了505次复苏。所有急救呼叫均统一记录。在这505次复苏中，154次初步成功（30.5%），58次次要成功，即患者最终出院。其中56例在复苏后至少5年可追踪后续病程（45例男性，11例女性；平均年龄57[10 - 83]岁）。分析了患者病历；51例患者的数据可从家庭医生、门诊护理或家访中获取。
34例患者（60.4%）在复苏后5年仍存活。复苏后第一年的死亡率最高（16%）。预后不良的因素包括：高龄（P < 0.01）、基础心脏病（n = 49；P < 0.025），尤其是冠心病（n = 34；P < 0.01）。原发性心室颤动和既往心肌梗死患者（n = 10）的预后比急性梗死患者（n = 24；P < 0.05）差。经超声心动图测量左心室功能受损的患者（P < 0.05）、患有心律失常（Lown III级和IV级）的患者（P < 0.05）以及有严重神经后遗症的患者（n = 8；P < 0.08）生存机会降低。
长期预后首先取决于复苏患者的基础状况，而不是复苏的情况。
