Saklayen M, Liss H, Markert R
Department of Medicine, Wright State University, Dayton, OH 45428, USA.
Medicine (Baltimore). 1995 Jul;74(4):163-75. doi: 10.1097/00005792-199507000-00001.
Cardiopulmonary resuscitation (CPR) has been used extensively in the hospital setting since its introduction over 3 decades ago. We reviewed the CPR records at 1 hospital during a 2-year period and the results from 113 published reports of inpatient CPR with a total patient population of 26,095. We compared the survival rates of patients following CPR and the pre-arrest and intra-arrest factors related to survival. At the hospital where CPR records were reviewed, 44% of patients initially survived following CPR, and the 1-year survival rate was 5%. Patients with shorter durations of CPR and those administered fewer procedures and medications during CPR survived longer than patients with prolonged CPR. Patients with witnessed cardiac arrests were more likely to survive than those with unwitnessed arrests. Also, patients with respiratory arrests had much better survival than patients with cardiopulmonary arrests. Worldwide, 113 studies showed a survival to discharge rate of 15.2% (United States = 15%, Canada = 16%, United Kingdom = 17%, other European countries = 14%). Patients were more likely to survive to discharge if they were treated in a community hospital (versus a teaching or Veterans Affairs hospital) or were younger. Patients with ventricular tachycardia or fibrillation were more likely to survive than those with asystole or electromechanical dissociation. Patient's location was related to outcome, with emergency room and coronary care unit patients more likely to survive than intensive care unit and general ward patients. Other factors related to better survival rates were respiratory arrest, witnessed arrest, absence of comorbidity, and short duration of CPR. Knowledge of the likelihood of survival following CPR for subgroups of the hospital population based on pre-arrest and intra-arrest factors can help patients, their families, and their physicians decide, with compassion and conviction, in what situations CPR should be administered.
自30多年前心肺复苏术（CPR）引入以来，它已在医院环境中广泛使用。我们回顾了一家医院在两年期间的心肺复苏记录以及113篇已发表的住院患者心肺复苏报告的结果，这些报告涉及的患者总数为26,095人。我们比较了心肺复苏术后患者的生存率以及与生存相关的心脏骤停前和心脏骤停期间的因素。在审查心肺复苏记录的医院中，44%的患者在心肺复苏术后最初存活，1年生存率为5%。心肺复苏持续时间较短以及在心肺复苏期间接受较少操作和药物治疗的患者比心肺复苏时间延长的患者存活时间更长。有目击心脏骤停的患者比无目击心脏骤停的患者更有可能存活。此外，呼吸骤停患者的生存率远高于心肺骤停患者。在全球范围内，113项研究显示出院生存率为15.2%（美国 = 15%，加拿大 = 16%，英国 = 17%，其他欧洲国家 = 14%）。如果患者在社区医院（与教学医院或退伍军人事务医院相比）接受治疗或年龄较小，则更有可能存活至出院。室性心动过速或颤动患者比心搏停止或电机械分离患者更有可能存活。患者的位置与预后相关，急诊室和冠心病监护病房的患者比重症监护病房和普通病房的患者更有可能存活。与更高生存率相关的其他因素包括呼吸骤停、目击心脏骤停、无合并症以及心肺复苏持续时间短。了解基于心脏骤停前和心脏骤停期间因素的医院人群亚组心肺复苏术后的生存可能性，有助于患者、其家属和医生在充满同情和信念的情况下决定在何种情况下应实施心肺复苏。
