Analysis of the influence factors of return of spontaneous circulation in 146 in-hospital cardiac arrest patients
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摘要: 目的:探讨院内心搏骤停(IHCA)患者心肺复苏后自主循环恢复(ROSC)的相关影响因素。方法:回顾性分析2018-08—2019-08期间本院急诊抢救室收治的146例IHCA患者的病例资料,据心肺复苏(CPR)后是否恢复自主循环分成ROSC组和复苏无效组,采用单因素分析IHCA患者ROSC的影响因素,再将单因素分析中P<0.3的因素纳入二元非条件Logistic回归分析。结果:共有146例IHCA患者符合准入条件,ROSC率为49.32%(72/146)。单因素分析结果示,ROSC组与复苏无效组两组之间年龄、是否合并脑出血、肾上腺素累积量、CPR持续时间的差异有统计学意义(P<0.05)。Logistic回归分析示:年龄(OR=0.951,95%CI:0.919~0.985,P=0.005),肾上腺素累积量(OR=0.628,95%CI:0.540~0.730,P<0.01)是IHCA患者ROSC的独立影响因素。结论:年龄、肾上腺素累积量可影响IHCA患者ROSC。Abstract: Objective: To explore related factors of return of spontaneous circulation(ROSC) rate of in-hospital cardiac arrest(IHCA) patients after cardiopulmonary resuscitation. Method: The clinical data of 146 IHCA patients admitted in the emergency department of our hospital from August 2018 to August 2019 were retrospectively analyzed, which were divided into ROSC and unsuccess groups. Univariate analysis would be the first step, and then the factors with probability less than 0.3 were included in the binary unconditional Logistic regression analysis. Result: A total of 146 cases of IHCA were enrolled for the analysis. The rate of ROSC was 49.32%(72/146). There were statistical differences in the age, cerebral hemorrhage, accumulated dosages of epinephrine and duration of cardiopulmonary resuscitation between the two groups in univariate analysis(P<0.05). Multivariate Logistic regression analysis showed that the age(OR=0.951, 95%CI:0.919-0.985, P=0.005) and the accumulated dosages of epinephrine(OR=0.628, 95%CI:0.540-0.730, P<0.01) were independent predictors of ROSC after IHCA.Conclusion: ROSC rate of IHCA patients were affected by age and the accumulated dosages of epinephrine.
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[1] Holmberg MJ,Ross CE,Fitzmaurice GM,et al.Annual Incidence of Adult and Pediatric In-Hospital Cardiac Arrest in the United States[J].Circ Cardiovasc Qual Outcomes,2019,12(7):e005580.
[2] Shao F,Li CS,Liang LR,et al.Incidence and outcome of adult in-hospital cardiac arrest in Beijing,China[J].Resuscitation,2016,102(1):51-56.
[3] 吴婷婷.急性冠脉综合征住院患者心搏骤停流行病学调查及风险预测模型的初步构建[D].福州:福建医科大学,2017.
[4] 李圆.急诊院内心搏骤停患者的临床特征及心肺复苏成功率的影响因素分析[D].乌鲁木齐:新疆医科大学,2018.
[5] 蔡志仕,方文革,陈惠鸿,等.院内心搏骤停预后的影响因素分析[J].创伤与急诊电子杂志,2019,7(1):16-21.
[6] 王立祥,孟庆义,余涛,等.2016中国心肺复苏专家共识[J].中华灾害救援医学,2017,5(1):1-23.
[7] Nolan JP,Berg RA,Andersen LW,et al.Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports:Update of the Utstein Resuscitation Registry Template for In-Hospital Cardiac Arrest:A Consensus Report From a Task Force of the International Liaison Committee on Resuscitation(American Heart Association,European Resuscitation Council,Australian and New Zealand Council on Resuscitation,Heart and Stroke Foundation of Canada,InterAmerican Heart Foundation,Resuscitation Council of Southern Africa,Resuscitation Council of Asia)[J].Resuscitation,2019,144:166-177.
[8] Soar J,Maconochie I,Wyckoff MH,et al.2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations[J].Resuscitation,2019,145:95-150.
[9] Andersen LW,Holmberg MJ,Berg KM,et al.In-Hospital Cardiac Arrest:A Review[J].JAMA,2019,321(12):1200-1210.
[10] 龙曼云,钟国强,陈蒙华.心血管病患者院内心脏骤停心肺复苏成功的相关影响因素研究[J].广西医学,2015,37(4):459-461.
[11] 黄国梁.气管插管呼吸支持对提高院内心脏骤停患者的预后效果研究[J].临床医学工程,2016,23(10):1343-1344.
[12] Gough C,Nolan JP.The role of adrenaline in cardiopulmonary resuscitation[J].Crit Care,2018,22(1):139.
[13] 王凡,张新超.心肺复苏药物治疗的新进展[J].临床急诊杂志,2019,20(1):30-32.
[14] Goldberger ZD,Chan PS,Berg RA,et al.Duration of resuscitation efforts and survival after in-hospital cardiac arrest:an observational study[J].Lancet,2012,380(9852):1473-1481.
[15] Funada A,Goto Y,Tada H,et al.Duration of cardiopulmonary resuscitation in patients without prehospital return of spontaneous circulation after out-of-hospital cardiac arrest:Results from a severity stratification analysis[J].Resuscitation,2018,124(1):69-75.
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