Prognostic Indicators of Survival Following Cardiopulmonary Resuscitation in Patients With Cardiac Arrest: a Single-institutional Study
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 120
- 试验地点
- 1
- 主要终点
- indicators of survival
研究概览
简要总结
Cardiopulmonary resuscitation (CPR) occurs approximately 200,000 times/yr in hospitals in the UnitedStates, with 18% of patients surviving to discharge. Just over half of these survivors are neurologically intact or with mild defiits at the time of discharge. Do-not-resuscitate (DNR) orders are used to withhold CPR from patients who are unlikely to benefi or for whom it is inconsistent with their treatment goals or personal preferences. It would be helpful to identify patients with a very low likelihood of survival to discharge neurologically intact or with mild defiits were they to experience cardiopulmonary arrest (CPA), so their physician can present the option of a DNR order. This information would also be useful anytime a patient raises the question of the likelihood of survival should they undergo CPA.The objective of this study was to determine key indicators for good outcome in patients with sudden cardiac arrest undergoing CPR and develop a prediction model to predict survival to hospital discharge in these patients.
详细描述
A CPR coordinator prospectively collected data for the CPR registry according to the Utstein-style guidelines. Te registry included the following information:
demographic data, comorbidities, whether the arrest was witnessed, the incidence of suspected or confrmed trauma, presumed arrest time; presence of bystander CPR, frst documented arrest rhythm by the emergency medical service (EMS) provider, any return of spontaneous circulation (ROSC), presence of ECPR, the presence of return of spontaneous heart beating (ROSB) after CPR, presumed cause of arrest; the application of therapeutic hypothermia and the use of coronary angiography(CAG) or percutaneous coronary intervention (PCI),24-hour survival, the presence of ROSC more than 20 min, hospital length of stay (LOS), survival to hospital discharge,Glasgow-Pittsburgh cerebral performance category (CPC) score at discharge, and the fnal diagnosis at discharge. Te comorbidity score was calculated using the Charlson comorbidity index. Te duration of CPR was defned as the time interval from the frst chest compression provided by healthcare providers to the termination of resuscitation eforts due to ROSC (more than 20 min),ROSB after CPR, or a declaration of death. A favorable neurologic outcome was defned as a CPC score of 1 or 2 on the fve-category scale.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 75 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •age more than 18 years,
- •sudden arrest with potentially reversible causes,
- •a short no fow time (time interval from presumed arrest to CPR initiation)
- •even for unwitnessed arrests
排除标准
- •presence of a terminal illness or malignancy, severe irreversible neurologic defcit,
- •suspected or confrmed traumatic origin of arrest,
- •no informed consent from the family
结局指标
主要结局
indicators of survival
时间窗: an average of 1 year
The survival outcome was analyzed with logstic regression
次要结局
未报告次要终点
研究者
GengLong Liu
Principal Investigator
First Affiliated Hospital, Sun Yat-Sen University
