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首页> 美国卫生研究院文献>Cardiology Research and Practice >Renal Insufficiency and Early Bystander CPR Predict In-Hospital Outcomes in Cardiac Arrest Patients Undergoing Mild Therapeutic Hypothermia and Cardiac Catheterization: Return of Spontaneous Circulation Cooling and Catheterization Registry (ROSCCC Registry)
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Renal Insufficiency and Early Bystander CPR Predict In-Hospital Outcomes in Cardiac Arrest Patients Undergoing Mild Therapeutic Hypothermia and Cardiac Catheterization: Return of Spontaneous Circulation Cooling and Catheterization Registry (ROSCCC Registry)

机译：肾功能不全和早期旁观者CPR预测接受轻度治疗性低温和心脏导管插入术的心脏骤停患者的院内结局：自发循环冷却和导管注册系统（ROSCCC注册系统）

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Objective. Out of hospital cardiac arrest (OHCA) patients are a critically ill patient population with high mortality. Combining mild therapeutic hypothermia (MTH) with early coronary intervention may improve outcomes in this population. The aim of this study was to evaluate predictors of mortality in OHCA patients undergoing MTH with and without cardiac catheterization. Design. A retrospective cohort of OHCA patients who underwent MTH with catheterization (MTH + C) and without catheterization (MTH + NC) between 2006 and 2011 was analyzed at a single tertiary care centre. Predictors of in-hospital mortality and neurologic outcome were determined. Results. The study population included 176 patients who underwent MTH for OHCA. A total of 66 patients underwent cardiac catheterization (MTH + C) and 110 patients did not undergo cardiac catheterization (MTH + NC). Immediate bystander CPR occurred in approximately half of the total population. In the MTH + C and MTH + NC groups, the in-hospital mortality was 48% and 78%, respectively. The only independent predictor of in-hospital mortality for patients with MTH + C, after multivariate analysis, was baseline renal insufficiency (OR = 8.2, 95% CI 1.8–47.1, and p = 0.009). Conclusion. Despite early cardiac catheterization, renal insufficiency and the absence of immediate CPR are potent predictors of death and poor neurologic outcome in patients with OHCA.
机译：目的。医院外心脏骤停（OHCA）患者是高危重症患者。将轻度低温治疗（MTH）与早期冠状动脉介入治疗相结合可能会改善该人群的预后。这项研究的目的是评估接受和不接受心脏导管的接受MTH的OHCA患者死亡率的预测指标。设计。在一个三级护理中心分析了2006年至2011年间接受导尿（MTH + C）和不进行导尿（MTH + NC）的MTH的OHCA患者的回顾性队列。确定了院内死亡率和神经系统结局的预测因子。结果。研究人群包括176例因OHCA接受MTH治疗的患者。共有66例患者接受了心脏导管检查（MTH + C），而110例未进行心脏导管检查（MTH + NC）。直接旁观者心肺复苏术发生在大约一半的总人口中。在MTH + C组和MTH + NC组中，住院死亡率分别为48％和78％。经多变量分析后，MTH + C患者住院死亡率的唯一独立预测因素是基线肾功能不全（OR = 8.2，95％CI 1.8–47.1，p = 0.009）。结论。尽管早期进行了心脏导管插入术，但肾功能不全和没有立即进行CPR仍是OHCA患者死亡和神经系统预后不良的有效预测指标。

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