病院外での心停止後の入院死亡率

N R Grubb¹, R A Elton, K A Fox

¹Cardiovascular Research, Units University of Edinburgh, Royal Infirmary of Edinburgh, UK.

Lancet (London, England)

|August 12, 1995

まとめ

病院外心停止 (OHCA) の後の入院死亡を予測することは極めて重要です. 逮捕リズムや入院時の意識レベルなどの要因は,死亡率を正確に予測し,蘇生訓練が結果を改善することを示唆しています.

科学分野:

緊急医療緊急医療
心臓病学心臓病学
クリティカルケア・メディシン

背景:

病院外心停止 (OHCA) の生存者の病院内管理は,予後不確実性の課題に直面しています.
有害なアウトカムのマーカーを特定することは,患者のケアを導くために不可欠です.

研究の目的:

初期OHCA蘇生を生き残った患者の入院死亡を予測する要因を特定する.
OHCAの生存者のための予後スコアシステムを開発する.

主な方法:

イギリスの単一のセンターで346件の連続したOHCA事件の遡及的および前向きな分析.
逮捕前,蘇生,入院前の変数を調査し,逮捕リズム,目撃者ステータス,グラスゴー昏睡スコアを含む.

主要な成果:

乗組員が目撃した逮捕は,死亡率の低下と関連していた.
アレストリズム,医療従事者の蘇生,入院意識レベル,換気は,独立して入院死亡率を予測した.
これらの要因に基づいた予後スコアは,将来的なグループの死亡を正確に予測した;持続的な昏睡>72時間は,不良の予後を示した.

結論:

OHCAの生存者の正確な予後評価は,入院時に実現可能である.
蘇生技師のスキルは,公共の蘇生訓練が死亡率を下げる可能性があることを示唆する,変更可能な要因です.

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