Complicated cardiac arrest and its resuscitation characteristics in patients with intracerebral hemorrhage: Chinese Stroke Center Alliance.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE

SHOCK Pub Date : 2024-10-02 DOI:10.1097/SHK.0000000000002486

Ping Lu, Lingyun Cui, Hongqiu Gu, Zixiao Li, Yi Ju, Yongjun Wang, Xingquan Zhao, Wenjuan Wang

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引用次数: 0

Abstract

Objective: Cardiac arrest (CA) is one of the most severe complications in patients with intracerebral hemorrhage (ICH), increasing the risk of death. This study explored the factors influencing CA occurrence and its resuscitation characteristics in ICH patients.

Methods: Data were retrieved from the Chinese Stroke Center Alliance database. The primary outcome was CA, and the secondary outcomes were in-hospital death and survival post-CA. Absolute standardized and rate differences were utilized for intergroup comparisons, while logistic regression was employed for correlation analysis.

Results: A total of 85,105 patients were enrolled in this study. Among them, 1651 (1.9%) patients experienced CA, of whom 1032 (62.5%) died in hospital. At baseline, prehospital notification from the emergency medical service system (PRE-EMS) was a co-factor influencing CA occurrence and the presence of a death outcome (OR: 1.71, 95% CI: 1.47-1.98, p < 0.001; OR: 0.50, 95% CI: 0.41-0.62, p < 0.001). In terms of complications, post-hospital hematoma expansion and swallowing dysfunction were co-factors influencing CA occurrence and the presence of a death outcome (OR: 3.78, 95% CI: 3.20-4.47, p < 0.001, OR: 1.39, 95% CI: 1.11-1.76; p < 0.001; OR: 7.66, 95% CI:5.48-10.70, p < 0.001, OR: 1.66, 95% CI: 1.08-2.57, p < 0.001). The incidence of CA in ICH patients decreased annually from 2015 to 2019, while survival after CA increased annually (p < 0.001).

Conclusions: PRE-EMS, posthospital hematoma expansion, and swallowing dysfunction were identified as co-factors contributing to CA occurrence and post-CA mortality following ICH. The proportion of CA patients following ICH decreased, while survival rates improved annually from 2015 to 2019.

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脑出血患者并发心脏骤停及其复苏特点：中国卒中中心联盟。

目的：心脏骤停（CA）是脑内出血（ICH）患者最严重的并发症之一，会增加死亡风险。本研究探讨了影响 ICH 患者发生 CA 的因素及其复苏特点：数据来自中国卒中中心联盟数据库。主要结果为CA，次要结果为院内死亡和CA后存活。组间比较采用绝对标准化和比率差异，相关分析采用逻辑回归：结果：共有 85 105 名患者参与了这项研究。其中，1651 名（1.9%）患者发生了急性心肌梗死，1032 名（62.5%）患者在住院期间死亡。在基线时，紧急医疗服务系统（PRE-EMS）的院前通知是影响 CA 发生和死亡结果的共同因素（OR：1.71，95% CI：1.47-1.98，p < 0.001；OR：0.50，95% CI：0.41-0.62，p < 0.001）。在并发症方面，入院后血肿扩大和吞咽功能障碍是影响CA发生和出现死亡结局的共同因素（OR：3.78，95% CI：3.20-4.47，p＜0.001；OR：1.39，95% CI：1.11-1.76；p＜0.001；OR：7.66，95% CI：5.48-10.70，p＜0.001；OR：1.66，95% CI：1.08-2.57，p＜0.001）。从2015年到2019年，ICH患者的CA发生率逐年下降，而CA后的存活率逐年上升（p < 0.001）：结论：急救前、入院后血肿扩大和吞咽功能障碍被认为是导致ICH后CA发生和CA后死亡率的共同因素。从2015年到2019年，ICH后CA患者的比例有所下降，而生存率逐年提高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

SHOCK 医学-外科

CiteScore

6.20

自引率

3.20%

发文量

199

审稿时长

1 months

期刊介绍： SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.