Factors Determining the Clinical Outcome in Patients Suffering Cardiac or Non-Cardiac out-of-Hospital Cardiac Arrest, Who Have Achieved Sustained ROSC in the Emergency Department

針對心因性及非心因性到院前心跳停止之病人經急救後恢復自發性循環的臨床特徵及預後相關因子

劉信良(Hsin-Liang Liu) ； 賴世昌(Shih-Chang Lai) ； 李肇瑞(Chao-Jui Li) ； 劉慈安(Tzu-An Liu) ； 吳宜芳(Yi-Fang Wu) ； 周志中(Chu-Chung Chou) ； 張進富(Chin-Fu Chang) ； 林晏任(Yan-Ren Lin)

《Journal of Emergency Medicine, Taiwan》 11卷3期 (2009/09) Pp. 77-85

摘要

Methods: This retrospective study comprised 482 patients, over 18 years of age, who were brought to the emergency department with non-traumatic OHCA (during Jan 2007 to Jan 2009). Patients who achieved sustained ROSC were divided into two groups: cardiac and non-cardiac OHCA, based on their possible etiologies. The differences in the characteristics of the patients, the clinical features and the outcomes were analyzed between the two groups. Time-related survival rates of both groups were calculated according to the duration of the hospital stay and factors associated with the chance of achieving sustained ROSC. The mean total duration of ROSC was also analyzed according to different in-hospital cardiopulmonary resuscitation (CPR) durations.
Results: Pre-hospital and in-hospital initial cardiac rhythms were both more shockable in cardiac than in non-cardiac OHCA (both P＜0.001). The most common etiologies of cardiac and non-cardiac OHCA were acute coronary syndrome (70.4%) and respiratory failure (32.5%), respectively. Patients aged from 66 to 80 years constituted the majority of non-traumatic OHCA cases and cardiac origin was mild predominant in this age group. The survival rates in non-cardiac OHCA decreased more rapidly than cardiac OHCA after the first day of hospital stay. Patients who were witnessed, or had ever received defibrillation by an automated external defibrillator, could achieve a longer duration of ROSC. Finally, patients who achieved their sustained ROSC within 10 minutes of in-hospital CPR could maintain the longest duration of ROSC in both groups.
Conclusion: Patients with cardiac OHCA presented a higher percentage of shockable rhythm than patients with non-cardiac OHCA, and this was mild predominant in patients aged from 66 to 80 years. We found that the outcomes of patients with cardiac OHCA were better than patients with non-cardiac OHCA after the first day of hospital stay.
Objective: The clinical features and outcomes of patients with sustained return of spontaneous circulation (ROSC) of out-ofhospital cardiac arrest (OHCA) are well known to be poor. The purpose of this study is to analyze the differences of outcomes in patients suffering cardiac or non-cardiac OHCA with sustained ROSC.

關鍵字

到院前心跳停止 ； 心因性 ； 非心因性 ； 復甦

並列摘要

Methods: This retrospective study comprised 482 patients, over 18 years of age, who were brought to the emergency department with non-traumatic OHCA (during Jan 2007 to Jan 2009). Patients who achieved sustained ROSC were divided into two groups: cardiac and non-cardiac OHCA, based on their possible etiologies. The differences in the characteristics of the patients, the clinical features and the outcomes were analyzed between the two groups. Time-related survival rates of both groups were calculated according to the duration of the hospital stay and factors associated with the chance of achieving sustained ROSC. The mean total duration of ROSC was also analyzed according to different in-hospital cardiopulmonary resuscitation (CPR) durations.
Results: Pre-hospital and in-hospital initial cardiac rhythms were both more shockable in cardiac than in non-cardiac OHCA (both P＜0.001). The most common etiologies of cardiac and non-cardiac OHCA were acute coronary syndrome (70.4%) and respiratory failure (32.5%), respectively. Patients aged from 66 to 80 years constituted the majority of non-traumatic OHCA cases and cardiac origin was mild predominant in this age group. The survival rates in non-cardiac OHCA decreased more rapidly than cardiac OHCA after the first day of hospital stay. Patients who were witnessed, or had ever received defibrillation by an automated external defibrillator, could achieve a longer duration of ROSC. Finally, patients who achieved their sustained ROSC within 10 minutes of in-hospital CPR could maintain the longest duration of ROSC in both groups.
Conclusion: Patients with cardiac OHCA presented a higher percentage of shockable rhythm than patients with non-cardiac OHCA, and this was mild predominant in patients aged from 66 to 80 years. We found that the outcomes of patients with cardiac OHCA were better than patients with non-cardiac OHCA after the first day of hospital stay.
Objective: The clinical features and outcomes of patients with sustained return of spontaneous circulation (ROSC) of out-ofhospital cardiac arrest (OHCA) are well known to be poor. The purpose of this study is to analyze the differences of outcomes in patients suffering cardiac or non-cardiac OHCA with sustained ROSC.

並列關鍵字

OHCA ； cardiac origin ； non-cardiac origin ； resuscitation