社区反应的趋势和儿科心脏骤停的长期结果:一项回顾性观察性研究
M Albrecht1, R C J de Jonge1, K Dulfer1
1Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
Resuscitation
|November 12, 2023
概括
在儿科医院外心脏骤停 (pOHCA) 中观察到更好的生存率,与自动外部除器 (AED) 使用量增加有关. 长期的认知结果,如总智商得分,随着时间的推移没有显著变化.
科学领域:
- 儿科急救医学 儿科急救医学
- 心脏病学 心脏病学
- 神经学 神经学
背景情况:
- 儿科医院外心脏骤停 (pOHCA) 结果和医院前因素需要进一步的大规模人口研究.
- 在pOHCA后的长期神经和神经心理结果至关重要,但描述不足.
研究的目的:
- 为了调查pOHCA的医院前因素的时间趋势.
- 分析pOHCA.后长期神经和神经心理结果的趋势.
- 为了确定与改善儿科心脏骤停的结果相关的因素.
主要方法:
- 对1天至17岁的非创伤性停止患者 (2002-2020年) 的回顾性分析.
- 纳入标准: 患者出现在索菲亚儿童医院.
- 统计分析:多变量逻辑和线性回归模型,以评估随时间推移的趋势,以事件年为独立变量. 作为儿科大脑性能类别 (PCPC) 定义的有利的神经结果 1-2.
主要成果:
- 在19年的研究期间,长期有利的神经结果 (PCPC 1-2) 的显著增加被观察到 (OR 1.10).
- 每年自动化外部除器 (AED) 的使用量显著增加 (OR 1.21).
- 在青少年中,初始可震动节奏也显著增加 (OR 1.15),而旁观者基本生命支持 (BLS) 率和总智商得分并没有随着时间的推移显著变化.
结论:
- 随着时间的推移,在儿科医院外心脏骤停后的长期有利的神经结果有所改善.
- 增加自动化外部除器 (AED) 的使用和青少年更高的可震动节律发病率是同时出现的趋势.
- 虽然神经功能有所改善,但整体认知得分 (总智商) 保持稳定,这表明需要进一步研究全面的长期康复.
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