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首页> 外文期刊>Acute Medicine & Surgery >Development of a prompt model for predicting neurological outcomes in patients with return of spontaneous circulation from out‐of‐hospital cardiac arrest
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Development of a prompt model for predicting neurological outcomes in patients with return of spontaneous circulation from out‐of‐hospital cardiac arrest

机译：建立快速模型以预测院外心脏骤停后自然循环恢复的患者的神经系统结果

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Aim Early prediction of the neurological outcomes of patients with out‐of‐hospital cardiac arrest is important to select the optimal clinical management. We hypothesized that clinical data recorded at the site of cardiopulmonary resuscitation would be clinically useful. Methods This retrospective cohort study included patients with return of spontaneous circulation after cardiopulmonary resuscitation who were admitted to our university hospital between J anuary 2000 and N ovember 2013 or two affiliated hospitals between J anuary 2006 and N ovember 2013. Clinical parameters recorded on arrival included age (A), arterial blood pH (B), time from cardiopulmonary resuscitation to return of spontaneous circulation (C), pupil diameter (D), and initial rhythm (E). Glasgow Outcome Scale was recorded at 6 months and a favorable neurological outcome was defined as a score of 4–5 on the Glasgow Outcome Scale. Multiple logistic regression analysis was carried out to derive a formula to predict neurological outcomes based on basic clinical parameters. Results The regression equation was derived using a teaching dataset (total, n ?=?477; favourable outcome, n ?=?55): EP ?=?1/(1?+?e~(?)~(x) ), where EP is the estimated probability of having a favorable outcome, and x ?=?(?0.023?×?A)?+?(3.296?×?B)???(0.070?×?C)???(1.006?×?D)?+?(2.426?×?E)???19.489. The sensitivity, specificity, and accuracy were 80%, 92%, and 90%, respectively, for the validation dataset (total, n ?=?201; favourable outcome, n ?=?25). Conclusion The 6‐month neurological outcomes can be predicted in patients resuscitated from out‐of‐hospital cardiac arrest using clinical parameters that can be easily recorded at the site of cardiopulmonary resuscitation.
机译：目的尽早预测院外心脏骤停患者的神经系统结局对于选择最佳临床治疗方法很重要。我们假设在心肺复苏部位记录的临床数据在临床上将是有用的。方法这项回顾性队列研究包括2000年1月至2013年11月之间入住我校医院或2006年1月至2013年11月之间入住两家附属医院的心肺复苏后自然循环恢复的患者。到达时记录的临床参数包括年龄（A），动脉血pH（B），从心肺复苏到自发循环恢复的时间（C），瞳孔直径（D）和初始心律（E）。格拉斯哥结果量表记录为6个月，神经系统的良好结局定义为格拉斯哥结果量表的4-5分。进行了多重逻辑回归分析，以基于基本临床参数推导可预测神经系统结果的公式。结果回归方程是使用教学数据集得出的（总计n = 477;有利结果n = 55）：EP = 1 /（1？+？e〜（？ ），其中EP是具有良好结果的估计概率，并且x≥＝（（0.023≥×ΔA）≥+（3.296××≥B）≤α。 △（0.070××C）×（1.006××D）×+（2.426××E）×19.489。对于验证数据集，灵敏度，特异性和准确性分别为80％，92％和90％（总计n = 201;有利结果n = 25）。结论院外心脏骤停复苏的患者可使用可在心肺复苏部位轻松记录的临床参数预测6个月的神经系统结局。

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