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首页> 外文期刊>Resuscitation. >Survival of severely shocked patients who present with absent radial pulse and unrecordable blood pressure in the pre-hospital phase.
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Survival of severely shocked patients who present with absent radial pulse and unrecordable blood pressure in the pre-hospital phase.

机译：重度休克患者的生存率，这些患者在院前期出现radial脉搏动缺失且血压无法记录。

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OBJECTIVES: To determine the mortality and clinical features of patients presenting with severe hypotension in the pre-hospital phase of care. DESIGN: A prospective observational study. The medical records of patients attended by a physician-led pre-hospital medical service were examined prospectively. Inclusion criteria were severe shock characterized by a non-palpable radial pulse and unrecordable blood pressure at clinical presentation. All consecutive records between September 2002 and September 2003 were included. SETTING: Seine Saint-Denis, an urban area with a population of 1.5 million located in the northern suburbs of Paris, France. INTERVENTIONS: None. RESULTS: One hundred and thirty one patients met the inclusion criteria. The overall mortality was 50% (66/131). Of the deaths, 20% (13/66) occurred in the pre-hospital phase and 80% (53/66) after arrival in hospital. Clinical features significantly associated with increased mortality were: more than one pre-existing co-morbidity, increased age, high Knaus score, a low Glasgow Coma Score, vasopressor administration, pre-hospital cardiac arrest and hypotension on arrival at hospital. The presence of anaphylactic shock was associated with low mortality. In multivariate analysis, occurrence of cardiac arrest (OR=13.5 [2.8; 64.5]), age (OR=1.03 [1.01; 1.05]) and low Glasgow Coma Scale score value (OR=1.15 [1.05; 1.29]) were independently associated with mortality. CONCLUSION: Patients presenting with profound hypotension in the pre-hospital phase have a high mortality. Patients who recover their blood pressure with interventions before hospital admission and those with anaphylactic shock have a better outcome than other patient sub-groups.
机译：目的：确定在院前护理阶段出现严重低血压的患者的死亡率和临床特征。设计：一项前瞻性观察研究。前瞻性地检查了由医生领导的院前医疗服务所护理的患者的病历。纳入标准为严重休克，其特征为临床表现为无法触及的径向脉搏和无法记录的血压。包括2002年9月至2003年9月之间的所有连续记录。地点：塞纳河圣但尼（Seine Saint-Denis），位于法国巴黎北郊，人口150万的市区。干预措施：无。结果：131例患者符合纳入标准。总死亡率为50％（66/131）。在死亡中，有20％（13/66）发生在医院前阶段，而80％（53/66）则在住院后发生。与死亡率增加显着相关的临床特征是：超过一种既存的合并症，年龄增加，可耐斯评分高，格拉斯哥昏迷评分低，血管加压药，住院前心脏骤停和到达医院时低血压。过敏性休克的存在与低死亡率相关。在多变量分析中，心脏骤停的发生（OR = 13.5 [2.8; 64.5]），年龄（OR = 1.03 [1.01; 1.05]）和低格拉斯哥昏迷量表评分值（OR = 1.15 [1.05; 1.29]）独立相关与死亡率。结论：在院前期出现严重低血压的患者死亡率较高。在入院前通过干预使血压恢复的患者和过敏性休克的患者比其他患者亚组的预后更好。

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