Gaul G B, Gruska M, Titscher G, Blazek G, Havelec L, Marktl W, Muellner W, Kaff A
Department of Cardiology, Hanuschkrankenhaus, Wiener Gebietskrankenkasse, Vienna, Austria.
Resuscitation. 1996 Oct;32(3):169-76. doi: 10.1016/0300-9572(96)00956-2.
The objective of this study was the assessment of out-of-hospital cardiac arrest and the definition of possible predictive factors for final hospital discharge. Out of a database of 89,557 consecutive missions of the Vienna emergency medical system (EMS) during 1990, there were 623 missions due to a collapse of non-traumatic origin: in 374 cases (60.0%) the patients were declared dead without further attempts at resuscitation. The remaining 249 patients were analysed for predictive factors at site. Survival to hospital admission: 109 patients survived to hospital admission (43.7%); bystander support had a small impact (P < 0.05) on survival to hospital arrival whereas age and gender had no predictive power. Most patients with ventricular tachycardia/fibrillation (VT/VF) survived primarily (69 of 117, i.e. 59.0%). Survival to hospital discharge: 27 patients were discharged from hospital care (10.8%). ECG findings on arrival of the EMS physician at the site proved to be the only powerful predictor for survival: 24 of 117 patients with VT/VF survived compared with only one of 81 with primary asystole, two of 39 with severe bradycardia, and no patient with electromechanical dissociation.
本研究的目的是评估院外心脏骤停情况，并确定最终出院的可能预测因素。在1990年维也纳紧急医疗系统（EMS）连续89557次任务的数据库中，有623次任务是由于非创伤性原因导致的晕倒：在374例（60.0%）患者中，未进行进一步复苏尝试即宣布死亡。其余249例患者在现场分析预测因素。入院存活情况：109例患者存活至入院（43.7%）；旁观者支持对存活至医院有较小影响（P < 0.05），而年龄和性别无预测能力。大多数室性心动过速/心室颤动（VT/VF）患者主要存活（117例中的69例，即59.0%）。出院存活情况：27例患者出院（10.8%）。EMS医生到达现场时的心电图表现被证明是存活的唯一有力预测因素：117例VT/VF患者中有24例存活，而81例原发性心脏停搏患者中仅有1例存活，39例严重心动过缓患者中有2例存活，电机械分离患者无存活者。
