Rogove H J, Safar P, Sutton-Tyrrell K, Abramson N S
Department of Anesthesiology, University of Pittsburgh Medical Center, PA. 15260.
Crit Care Med. 1995 Jan;23(1):18-25. doi: 10.1097/00003246-199501000-00007.
To assess survival after cardiac arrest and to determine whether age is an independent determinant of late mortality or poor neurologic outcome.
Analyses using results of Brain Resuscitation Clinical Trial I (1979 to 1984) and Brain Resuscitation Clinical Trial II (1984 to 1989), two randomized, double-blind studies of outcome following cardiac arrest.
A multicenter study in 12 acute care hospitals in nine countries (Brain Resuscitation Clinical Trial I), and 24 hospitals in eight countries (Brain Resuscitation Clinical Trial II).
A total of 774 patients who were initially comatose after successful resuscitation from cardiac arrest. The analyses include both in- and out-of-hospital cardiac arrests.
The 6-month mortality rate for the entire group was 81%. Mortality rate was 94% for the oldest group (> 80 yrs) compared with 68% for the youngest group (< or = 45 yrs) (p < .01). Other independent predictors of mortality were history of diabetes mellitus, inhospital arrests, arrest time of > 5 mins, history of congestive heart failure, a noncardiac cause of arrest, and cardiopulmonary resuscitation time of > 20 mins. Of the 774 patients, 27% recovered good neurologic function. There was no statistically significant difference in neurologic recovery rates by age. Multivariate analysis showed that independent predictors of good neurologic recovery were: no history of diabetes mellitus, a cardiac cause of arrest, short arrest time, and short cardiopulmonary resuscitation time.
Increasing age was a factor in postresuscitation mortality, but was not an independent predictor of poor neurologic outcome.
评估心脏骤停后的生存率，并确定年龄是否是晚期死亡率或不良神经学转归的独立决定因素。
采用脑复苏临床试验I（1979年至1984年）和脑复苏临床试验II（1984年至1989年）的结果进行分析，这两项是关于心脏骤停后转归的随机、双盲研究。
一项多中心研究，脑复苏临床试验I在9个国家的12家急症医院进行，脑复苏临床试验II在8个国家的24家医院进行。
共有774例患者在心脏骤停成功复苏后最初处于昏迷状态。分析包括院内心脏骤停和院外心脏骤停。
整个组的6个月死亡率为81%。年龄最大组（>80岁）的死亡率为94%，而最小组（≤45岁）为68%（p<0.01）。其他死亡率的独立预测因素包括糖尿病史、院内心脏骤停、骤停时间>5分钟、充血性心力衰竭史、非心脏性骤停原因以及心肺复苏时间>20分钟。在774例患者中，27%恢复了良好的神经功能。按年龄分层的神经功能恢复率无统计学显著差异。多因素分析显示，神经功能良好恢复的独立预测因素为：无糖尿病史、心脏性骤停原因、短骤停时间和短心肺复苏时间。
年龄增加是复苏后死亡率的一个因素，但不是不良神经学转归的独立预测因素。
