[Clinical characteristics and risk factors for mortality in perioperative cardiac arrest patients].

Q3 Medicine
Y Song, J H Wang, H Zhang, C Xu, Y C Xu, Q B Ma
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引用次数: 0

Abstract

Objective: To summarize the clinical characteristics and explore the risk factors for in-hospital mortality in patients experiencing perioperative cardiac arrest (PCA). Methods: This study retrospectively analyzed the clinical data of patients who experienced PCA at Peking University Third Hospital from January 1, 2012, to June 30, 2022. Patients were classified into survival and non-survival groups based on their discharge outcome. Demographic characteristics, surgical information, anesthesia methods, and postoperative complications were compared between the two groups. Furthermore, a multivariable logistic regression model was employed to identify independent predictors for in-hospital mortality in PCA patients. Results: This study included a total of 225 PCA patient (152 males and 73 females), with a mean age of (60.0±17.0) years. Among them, 190 patients (84.4%) died in-hospital and 35 (15.6%) patients survived to discharge. Patients in the survivor group were significantly younger than those in the non-survivor group[(53.5±16.4) vs (61.2±16.9) years, P=0.015], and had a lower incidence of postoperative major adverse cardiovascular events (MACE) [11.4%(4/35) vs 56.8%(108/190), P<0.001], acute kidney injury [0 vs 16.0%(30/190), P=0.006], acute liver injury [0 vs 12.6%(24/190),P=0.031]. Even after adjusting for key clinical variables including age, sex, diabetes mellitus, duration of cardiopulmonary resuscitation, and the use of norepinephrine and dopamine for resuscitation, multivariable logistic regression analysis indicated that postoperative MACE remained an risk factor for in-hospital mortality in PCA patients (OR=12.18, 95%CI: 2.62-56.64, P=0.001). Conclusions: This study demonstrates a high in-hospital mortality rate among patients experiencing perioperative cardiac arrest, survivors are typically younger and experienced a lower incidence of postoperative complications. Postoperative MACE is identified as an independent predictor of in-hospital mortality in PCA patients.

[围手术期心脏骤停患者的临床特点及死亡危险因素]
目的:总结围手术期心脏骤停(PCA)患者的临床特点,探讨其院内死亡的危险因素。方法:回顾性分析2012年1月1日至2022年6月30日北京大学第三医院行PCA患者的临床资料。根据出院结果将患者分为生存组和非生存组。比较两组患者的人口学特征、手术信息、麻醉方式及术后并发症。此外,采用多变量logistic回归模型来确定PCA患者住院死亡率的独立预测因素。结果:本研究共纳入225例PCA患者,其中男性152例,女性73例,平均年龄(60.0±17.0)岁。其中住院死亡190例(84.4%),存活出院35例(15.6%)。生存组患者明显比非生存组患者年轻[(53.5±16.4)岁vs(61.2±16.9)岁,P= 0.015],术后主要心血管不良事件(MACE)发生率[11.4%(4/35)vs 56.8%(108/190), PP=0.006],急性肝损伤发生率[0 vs 12.6%(24/190),P=0.031]。即使在调整了年龄、性别、糖尿病、心肺复苏持续时间、去甲肾上腺素和多巴胺复苏使用等关键临床变量后,多变量logistic回归分析显示,术后MACE仍然是PCA患者住院死亡率的危险因素(OR=12.18, 95%CI: 2.62-56.64, P=0.001)。结论:本研究表明围手术期心脏骤停患者的住院死亡率较高,幸存者通常较年轻,术后并发症发生率较低。术后MACE被确定为PCA患者住院死亡率的独立预测因子。
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
Zhonghua yi xue za zhi
Zhonghua yi xue za zhi Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
400
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