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| Analysis of Prognostic Influencing Factors in Patients with Out-of-Hospital Cardiac Arrest |
| ZHANG Yao, DAI Ren, ZHONG Longlong |
| Shanghai Songjiang District Medical Emergency Center, Shanghai 201620 |
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Abstract 【Objective】 To explore the risk factors of poor prognosis at discharge in patients with out-of-hospital cardiac arrest (OHCA). 【Methods】 A retrospective analysis was conducted on the clinical data of 264 OHCA patients treated by Shanghai Songjiang District Medical Emergency Center from January 2022 to January 2024. According to the survival status at discharge, the patients were divided into survival group (n=182) and death group (n=82). Univariate analysis and multivariate Logistic regression analysis were used to screen the independent risk factors affecting the prognosis of patients at discharge. 【Results】 Univariate analysis showed that there were statistically significant differences between the survival group and the death group in bystander CPR, no-reflow time, CPR duration, epinephrine dosage, lactic acid level, APACHE Ⅱ score and WIC score (P<0.05). Multivariate Logistic regression analysis showed that no bystander CPR, no-reflow time > 5 min, CPR duration > 15 min, epinephrine dosage > 5 mg, high APACHE Ⅱ score, elevated lactic acid level and high WIC score were all independent risk factors for in-hospital death of OHCA patients (P<0.05). 【Conclusion】 The discharge prognosis of OHCA patients is closely related to bystander CPR implementation, no-reflow time, CPR duration, epinephrine dosage, APACHE Ⅱ score, lactic acid level and WIC score. Medical staff can carry out early intervention and optimize cardiopulmonary resuscitation measures according to the specific conditions of patients.
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Received: 07 May 2025
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[1] 王海珍,程鹏飞,杨旻斐,等. 院外心脏骤停患者生存率预测模型的系统评价[J].中华急诊医学杂志,2023,32(7):895-902. [2] 徐定华,马青变. 心脏骤停后脑微循环障碍的机制及其干预措施研究进展[J].中国急救医学,2018,38(8):732-735. [3] 丁瑶. 亚低温联合体外膜肺氧合抢救心脏骤停患者的研究进展[J].中国循环杂志,2023,38(3):366-370. [4] 张国强. 心脏骤停及心肺复苏技术的现状、挑战与机遇[J].中华急诊医学杂志,2023,32(1):1-5. [5] 白雪,陈梦飞,唐玉娇,等. 心搏骤停流行病学调查及其危险因素研究现状[J].中华危重病急救医学,2024,36(4):445-448. [6] 楼亨通,陆远强. 非外伤性院外心脏骤停患者预后危险因素分析及列线图模型的构建[J].中华危重症医学杂志(电子版),2023,16(3):177-186. [7] KNAUS W A, DRAPER E A, WAGNER D P, et al. APACHE Ⅱ: a severity of disease classification system[J].Crit Care Med,1985,13(10):818-829. [8] CHARLSON M E,POMPEI P,ALES K L, et al. A new method of classifying prognostic comorbidity in longitudinal studies:development and validation[J].J Chronic Dis,1987,40(5):373-383. [9] 杨风梅,冯顺易,王文杰,等. 院外心脏骤停患者出院存活的危险因素与列线图预测模型构建[J].中国急救医学,2022,42(12):1034-1038. [10] YAN S J, GAN Y, JIANG N, et al. The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis[J].Crit Care,2020, 24(1): 61. [11] GRUNAU B E, GUY A, KAWANO T, et al. The association between no-flow interval and neurological outcomes in out-of-hospital cardiac arrest: implications for rescuer response, initiating resuscitation, and ECPR candidacy evaluation[J].Circulation,2019, 140(Suppl 2): A235. [12] GE W W, ZHENG G H, JI X F, et al. Effects of polyethylene glycol-20k on coronary perfusion pressure and postresuscitation myocardial and cerebral function in a rat model of cardiac arrest[J].J Am Heart Assoc,2020, 9(3): e014232. [13] OGHIFOBIBI O A, TOADER A E, NICHOLAS M A, et al. Resuscitation with epinephrine worsens cerebral capillary no-reflow after experimental pediatric cardiac arrest: An in vivo multiphoton microscopy evaluation[J].J Cereb Blood Flow Metab,2022, 42(12): 2255-2269. |
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