Kimman G P, Ivens E M, Hartman J A, Hart H N, Simoons M L
Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
Resuscitation. 1994 Dec;28(3):227-32. doi: 10.1016/0300-9572(94)90068-x.
Between 1983 and 1989, 962 patients in Rotterdam were resuscitated outside hospital, of whom 240 (25%) could be discharged alive. A follow-up study was performed to determine prognosis in these patients. Of the 240 survivors of out-of-hospital resuscitation 80% survived after 1 year and 61% after 5 years. During the first year, 9% suffered from myocardial (re)infarction and 13% underwent coronary bypass surgery or angioplasty. Within the first 3 years after resuscitation 60% of the patients were readmitted to hospital. Permanent or temporary neurological deficits were observed in 30 patients (14%). Patients with a primary arrhythmia without myocardial infarction had a worse prognosis than patients with a cardiac arrest in the context of an infarct. Survival was better in patients in whom resuscitation was initiated by physicians or ambulance-nurses, than in patients resuscitated by lay-people. Multivariate analysis revealed that this difference could be explained by a larger proportion of patients with a primary arrhythmia in the latter group. Since long-term prognosis after out-of-hospital resuscitation is satisfactory, programmes for resuscitation courses should be stimulated. Such programmes should aim predominantly at relatives of patients with known heart disease, police officers and children.
1983年至1989年间，鹿特丹有962名患者在院外接受了心肺复苏，其中240人（25%）存活出院。进行了一项随访研究以确定这些患者的预后情况。在240名院外心肺复苏幸存者中，80%在1年后存活，61%在5年后存活。在第一年，9%的患者发生心肌（再）梗死，13%的患者接受了冠状动脉搭桥手术或血管成形术。在心肺复苏后的前3年内，60%的患者再次入院。30名患者（14%）出现了永久性或暂时性神经功能缺损。原发性心律失常而非心肌梗死患者的预后比梗死情况下心脏骤停患者的预后更差。由医生或救护护士开始进行心肺复苏的患者的存活率高于由非专业人员进行心肺复苏的患者。多因素分析显示，后一组中原发性心律失常患者比例较高可以解释这种差异。由于院外心肺复苏后的长期预后情况令人满意，应推动心肺复苏课程项目开展。此类项目应主要针对已知患有心脏病患者的亲属、警察和儿童。
