Study on the Influencing Factors of Resuscitation Outcomes in Emergency Department Cardiac Arrest Patientswith Cardiac Arrest in Emergency Department

LI Shengtao; PENG Hanwu; LUO Ruqiao; SHI Aoli; LI Guoqing

PDF(1911 KB)

Journal of Hunan Normal University(Medical Science) ›› 2024, Vol. 21 ›› Issue (6) : 49-54.

Study on the Influencing Factors of Resuscitation Outcomes in Emergency Department Cardiac Arrest Patientswith Cardiac Arrest in Emergency Department

LI Shengtao, PENG Hanwu, LUO Ruqiao, SHI Aoli, LI Guoqing

Author information +

History +

Abstract

Objective To explore the relevant factors affecting the resuscitation outcomes of emergency department cardiac arrest patients. Methods A retrospective analysis was conducted on the medical records of 102 patients who underwent cardiopulmonary resuscitation (CPR) in the emergency department of a tertiary hospital in Changsha from April 2023 to June 2024. The patients were divided into two groups based on outcome indicators: the CPR ineffective group and the CPR effective group. Univariate analysis was used to determine the influencing factors of resuscitation outcomes in patients with cardiac arrest, and multiple logistic regression analysis was conducted. Based on the regression results, a prediction model was constructed to analyze the predictive value of each factor on the prognosis of patients with cardiac arrest. Results A total of 102 patients were included in this study, with 51 in the ineffective group of central pulmonary resuscitation and 51 in the effective group of cardiopulmonary resuscitation. Univariate analysis showed that there were statistically significant differences in the location of cardiac arrest, cumulative use of adrenaline, disease system and category that caused cardiac arrest, duration of cardiopulmonary resuscitation (CPR), and blood gas pH value; Multivariate logistic regression analysis showed that the cumulative use of adrenaline, pH value less than 7.35, and CPR duration were independent factors affecting the resuscitation outcome of emergency department cardiac arrest patients. Compared with circulatory system diseases, patients with sudden cardiac arrest due to digestive system diseases had a higher success rate of resuscitation; Based on the multi factor logistic regression results, the area under the receiver operating characteristic curve (ROC) of the constructed prediction model is 0.816 (95% CI: 0.736-0.895). Conclusion The cumulative use of adrenaline, disease system, CPR duration, and patient's blood gas pH are important factors affecting the outcome of patient resuscitation, which can be used to predict the prognosis of cardiac arrest patients. Close attention and active intervention are needed to further improve the success rate of treatment.

Key words

emergency department / cardiac arrest / cardiopulmonary resuscitation / return of spontaneous circulation

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

LI Shengtao, PENG Hanwu, LUO Ruqiao, SHI Aoli, LI Guoqing. Study on the Influencing Factors of Resuscitation Outcomes in Emergency Department Cardiac Arrest Patientswith Cardiac Arrest in Emergency Department[J]. Journal of Hunan Normal University(Medical Science). 2024, 21(6): 49-54

References

[1] 谭宇君. 淋巴细胞与单核细胞比值预测心脏骤停ROSC患者预后研究[D]. 长沙: 中南大学, 2023.
[2] ANDERSEN L W, HOLMBERG M J, BERG K M, et al.In-Hospital Cardiac Arrest: A Review[J]. JAMA, 2019, 321(12): 1200-1210.
[3] BENJAMIN E J, VIRANI S S, CALLAWAY C W, et al.Heart Disease and Stroke Statistics-2018 Update: a report from the American Heart Association[J]Circulation, 2018; 137(12): e67-e492.
[4] 中国医疗保健国际交流促进会胸痛分会. 中国心脏骤停与心肺复苏报告 (2022 年版)[M]. 北京: 人民卫生出版社, 2023.
[5] KOSUGI S, SHINOUCHI K, UEDA Y, et al.Clinical and angiographic features of patients with out-of-hospital cardiac arrest and acute myocardial infarction[J]. J Am Coll Cardiol, 2020, 76(17): 1934-1943.
[6] 辛小云, 刘荣妹, 仲芳玉. 心脏骤停患者院前心肺复苏抢救效果的影响因素分析[J]. 蛇志, 2022, 34(04): 489-492.
[7] STANKOVIC N, HOLMBERG MJ, HØYBYE M, et al. Age and sex differences in outcomes after in-hospital cardiac arrest[J]. Resuscitation, 2021, 165: 58-65.
[8] TSAI CL, LU TC, WANG CH, et al.Trajectories of vital signs and risk of in-hospital cardiac arrest[J]. Front Med (Lausanne), 2022, 8: 800943.
[9] 成洪. 急诊科心脏骤停患者心肺复苏成功的影响因素分析[J]. 中外医学研究, 2022, 20(08): 123-126.
[10] ABRAMS D, MACLAREN G, LORUSSO R, et al.Extracorporeal cardiopulmonary res uscitation in adults: evidence and implications[J]. Intensive Care Med, 2022, 48(1): 1-15.
[11] SANDRONI C, NOLAN JP, ANDERSEN LW, et al.ERC-ESICM guidelines on temper ature control after cardiac arrest in adults[J]. Intensive Care Med, 2022, 48(3): 261-269.
[12] 梁顺达. 院内心搏骤停患者自主循环恢复影响因素的分析研究[D]. 合肥: 安徽医科大学, 2023.
[13] 刘百求, 李静, 王美堂. 146例院内心搏骤停患者自主循环恢复的影响因素分析[J]. 临床急诊杂志, 2020, 21(05): 341-345.
[14] 张莹, 张海伶. 168例心肺复苏患者的抢救体会及其影响因素分析[J]. 心血管康复医学杂志, 2016, 25(06): 616-619.
[15] 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[J]. Circulation, 2019,140(18):746-757.
[16] SEDER DB, SUNDE K, RUBERTSSON S, et al.Neurologic outcomes and postresuscitation care of patients with myoclonus following cardiac arrest[J]. CritCare Med, 2015, 43(5): 965-972.
[17] 章楠, 邵俊, 方诗园, 等. 院外心搏骤停患者院前恢复自主循环的影响因素分析[J]. 中华灾害救援医学, 2022, 10(06): 314-318.
[18] 张春艳, 孟宇, 池菲, 等. 急诊科心肺复苏后患者自主循环恢复的影响因素[J]. 河北医药, 2021, 43(07): 1009-1012+1017.
[19] 王倩飞, 王晨曦, 何莉莉, 等. 麻杏饮治疗慢性阻塞性肺疾病急性加重期呼吸肌疲劳的疗效及对肺功能、血气分析指标、炎症因子的影响[J]. 河北中医, 2021, 43(09): 1444-1448.
[20] 孙峰, 张华忠, 梅勇, 等. 早期乳酸判断体外心肺复苏患者预后的研究[J]. 中华急诊医学杂志, 2022, 31(12): 1608-1611.
[21] 吕林, 胡海, 曹钰. 早期预测危重多发伤患者生存时间的指标分析[J]. 华西医学, 2016, 31(10): 1641-1644.
[22] 干金文, 马美娟, 金刚, 等. 影响急诊科心肺复苏患者复苏结局的危险因素探讨[J]. 检验医学与临床, 2022, 19(20): 2751-2754.
[23] 田孝瑞, 李晓召, 朱娟, 等. 碳酸氢钠林格液限制性复苏对创伤引发的失血性休克患者复苏效果及预后的影响[J]. 海南医学, 2024, 35(05): 620-624.
[24] 冯晓伟, 付亚帅. Lucas2心肺复苏仪器用于急诊科心脏骤停的临床效果[J]. 海南医学, 2022, 33(08): 990-992.
[25] 谢谦, 生娣, 廖光冲, 等. 床旁超声联合颅内血流监测预测心肺复苏患者颅内压升高的效果研究[J]. 现代生物医学进展, 2023, 23(23): 4473-4477.
[26] 张瑞洁, 李晶华, 马天娇, 等. 辽宁省某县级医院循环系统疾病老年患者住院费用影响因素分析[J]. 医学与社会, 2020, 33(02): 50-52+81.
[27] 石琳, 张冰. 张冰从肝论治消化系统疾病的学术思想与临床经验[J]. 中华中医药杂志, 2021, 36(05): 2737-2740.
[28] 成人院内心肺复苏质量控制临床实践专家组. 成人院内心肺复苏质量控制临床实践专家共识[J]. 中华急诊医学杂志, 2018, 27(8): 850-853.
[29] 李嘉, 覃朝晖, 李亦琛, 等. 基于柯式评估模型的本科新生心肺复苏培训效果评价[J]. 中国急救医学, 2024, 44(11): 971-976.
[30] FUNADA A, GOTO Y, TADA H, et al.Duration of cardiopulmonary resuscitationin patients without prehospital return of spontaneous circulation after out-of-hospital cardiac arrest: Results from a severity stratification analysis[J]. Resuscitation, 2018, 124: 69-75.
[31] 刘扬, 何小军, 张进军, 等. 院外心脏骤停心肺复苏终止的时机与指征[J]. 中华急诊医学杂志, 2022, 31(1): 115-119.
[32] 刘肖, 王聪. 急诊猝死患者的心肺复苏时间情况调查及影响因素分析[J]. 中国医刊, 2023, 58(08): 891-894.
[33] 赵婷婷, 赵媛媛, 邢吉红. 成人院内心脏骤停患者临床特征及复苏结局影响因素分析[J]. 协和医学杂志, 2023, 14(03): 536-542.
[34] 周夷霞, 韩文文, 宋丹丹. 心脏骤停患者心肺复苏后影响自主循环及预后的因素[J]. 心电与循环, 2020, 39(03): 251-255.