新加坡一家三级医疗中心在上班时间和下班时间发生的院内心脏骤停的结果。

Jong-Chie Claudia Tien, Yi Hao Edgarton Ching, Hui Li Tan, Jun Jie Lee, Kah Lai Carrie Leong
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引用次数: 0

摘要

导言:院内心脏骤停(IHCA)是一项重大的医疗负担,但在新加坡却缺乏相关数据。包括心脏骤停时间在内的各种因素都会影响急性复苏后的存活率:这是一项回顾性队列研究,评估了一家三甲医院连续发生的 220 例心脏骤停患者的特征,包括院内心脏骤停复苏后存活率(CASPRI)评分,以及骤停时间的影响。主要结果是心外复苏后自发循环恢复率(ROSC),次要结果是90天存活率:非上班时间和上班时间 IHCA 患者的 ROSC 率分别为 69.5% 和 75.4%(几率比 [OR] 0.74,95% 置信区间 [CI]0.39-1.42)。两组的 CASPRI 评分在统计学上无明显差异。经过调整分析后,上班时间外与上班时间内相比,IHCA 后 ROSC 的 OR 为 0.78(95% 置信区间 [CI]:0.39-1.53)。在非办公时间和办公时间内进行 IHCA 的患者的 90 天存活率分别为 25.7% 和 34.6%(OR 0.65,95% CI 0.32-1.34)。调整后的90天生存率为0.66(0.28-1.59):这项观察性研究的结果表明,心脏骤停的时间与ROSC率或90天存活率之间并无关联。
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Outcomes of in-hospital cardiac arrests during and after office hours in a single tertiary centre in Singapore.

Introduction: In-hospital cardiac arrest (IHCA) is a significant healthcare burden with a paucity of data in Singapore. Various factors, including time of cardiac arrest, affect survival from acute resuscitation.

Methods: This was a retrospective cohort study that evaluated the characteristics of patients who sustained an IHCA, including the Cardiac Arrest Survival Post Resuscitation In-hospital (CASPRI) scores, and the impact of arrest time in 220 consecutive cardiac arrests occurring in a tertiary hospital. The primary outcome was rate of return of spontaneous circulation (ROSC) post-IHCA, and the secondary outcome was 90-day survival.

Results: The ROSC rate among patients with IHCA out of and during office hours was 69.5% and 75.4%, respectively (odds ratio [OR] 0.74, 95% confidence interval [CI] 0.39-1.42). There were no statistically significant differences between the CASPRI scores of both groups. After adjusted analysis, the OR of ROSC post-IHCA out of office hours as compared to that during office hours was 0.78 (95% CI 0.39-1.53). The 90-day survival rate of patients who had an IHCA out of and during office hours was 25.7% and 34.6%, respectively (OR 0.65, 95% CI 0.32-1.34). The adjusted OR of 90-day survival was 0.66 (0.28-1.59).

Conclusion: The results of this observational study did not show an association between the timing of cardiac arrest and the rate of ROSC or 90-day survival.

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