左心室缩功能和医院内心脏骤停后的结果
Maria M Gonzalez1, Robert A Berg, Vinay M Nadkarni
1Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.
预先停止的左心室缩功能障碍显著降低了心脏骤停后的生存率. 中度至重度功能障碍患者的生存率为8%,正常功能患者的生存率为19%.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 左心室喷射分数 (LVEF) 对心脏骤停结果的影响尚不清楚.
- 左心室缩功能是心血管健康的关键决定因素.
研究的目的:
- 为了研究停顿前左心室喷射率 (LVEF) 与住院心脏骤停后的存活率之间的关联.
- 为了比较患有正常或受损LVEF的心脏骤停前患者的结果.
主要方法:
- 长达26个月的800名住院患者的心脏骤停的前性观察研究.
- 在613名患者 (77%) 中,分析了LVEF的预停病心声图 (77%).
- 使用逻辑回归来比较LVEF>=45%和LVEF<45%的患者之间的存活到出院的比较.
主要成果:
- 与正常/接近正常的LVEF (19%) 相比,中度/严重LVEF功能障碍 (8%) 的患者的脱离期生存率明显较低 (调整后OR为4.8,P<0.001).
- 在自发循环的回归 (59%与56%) 或24小时生存率 (39%与36%) 中没有显著差异.
- 在两组中,LVEF在逮捕后显著下降,百分比下降率相似 (25%对26%).
结论:
- 中度和严重的心脏停止前左心室缩功能障碍与心脏停止后医院出院的生存率大幅降低有关.
- 在心脏骤停前,LVEF是心脏骤停患者的关键预后因素.
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