基于院内心脏骤停和插管位置的体外心肺复苏术后存活率：体外生命支持组织登记分析。

IF 7.7 1区医学 Q1 CRITICAL CARE MEDICINE

Critical Care Medicine Pub Date : 2024-10-09 DOI:10.1097/CCM.0000000000006439

Michael Mazzeffi, Akram Zaaqoq, Jonathan Curley, Jessica Buchner, Isaac Wu, Jared Beller, Nicholas Teman, Laurent Glance

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引用次数: 0

摘要

目的：探讨体外心肺复苏（ECPR）死亡率是否因院内心脏骤停地点而异，以及移动患者进行插管是否会影响结果：探讨体外心肺复苏（ECPR）死亡率是否因院内心脏骤停地点而异，以及移动患者进行插管是否会影响结果：设计：回顾性队列研究：向体外生命支持组织（ELSO）报告数据的ECPR医院：干预措施：无：干预措施：无：记录患者人口统计学特征、合并症、心脏骤停前情况、ECPR前血管加压素使用情况、心脏骤停详情、ECPR插管信息、主要并发症和院内死亡率。采用多变量逻辑回归模型来研究院内死亡率与以下两个因素之间的关系：1）心脏骤停的位置；2）移动患者进行 ECPR 插管。共有 2515 名患者符合入选标准。与心导管室相比，在重症监护室发生心脏骤停的患者（aOR，1.85；95% CI，1.45-2.38；p < 0.001）和在急诊病床发生心脏骤停的患者（aOR，1.68；95% CI，1.09-2.58；p = 0.02）的调整后死亡率几率比（aOR）增加。移动患者进行插管与死亡率无关（aOR，0.70；95% CI，0.18-2.81；p = 0.62）。患者年龄越大，死亡率越高。具体来说，与 30 岁以下的患者相比，60-69 岁和 70 岁或以上的患者更容易死亡（aOR，1.71；95% CI，1.17-2.50；p = 0.006 和 aOR，2.27；95% CI，1.49-3.48；p < 0.001）：与其他地点相比，在重症监护室和急诊病床上经历心脏骤停的 ECPR 患者的死亡几率更高。移动患者进行 ECPR 插管与改善预后无关。

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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Survival After Extracorporeal Cardiopulmonary Resuscitation Based on In-Hospital Cardiac Arrest and Cannulation Location: An Analysis of the Extracorporeal Life Support Organization Registry.

Objectives: Explore whether extracorporeal cardiopulmonary resuscitation (ECPR) mortality differs by in-hospital cardiac arrest location and whether moving patients for cannulation impacts outcome.

Design: Retrospective cohort study.

Setting: ECPR hospitals that report data to the Extracorporeal Life Support Organization (ELSO).

Patients: Patients having ECPR for in-hospital cardiac arrest between 2020 and 2023 with data in the ELSO registry.

Interventions: None.

Measurements and main results: Patient demographics, comorbidities, pre-cardiac arrest conditions, pre-ECPR vasopressor use, cardiac arrest details, ECPR cannulation information, major complications, and in-hospital mortality were recorded. Multivariable logistic regression model was used to examine the associations between in-hospital mortality and 1) cardiac arrest location and 2) moving a patient for ECPR cannulation. A total of 2515 patients met enrollment criteria. The adjusted odds ratio (aOR) for mortality was increased in patients who had a cardiac arrest in the ICU (aOR, 1.85; 95% CI, 1.45-2.38; p < 0.001) and in patients who had a cardiac arrest in an acute care bed (aOR, 1.68; 95% CI, 1.09-2.58; p = 0.02) compared with the cardiac catheterization laboratory. Moving a patient for cannulation had no association with mortality (aOR, 0.70; 95% CI, 0.18-2.81; p = 0.62). Advanced patient age was associated with increased mortality. Specifically, patients 60-69 and patients 70 years old or older were more likely to die compared with patients younger than 30 years old (aOR, 1.71; 95% CI, 1.17-2.50; p = 0.006 and aOR, 2.27; 95% CI, 1.49-3.48; p < 0.001, respectively).

Conclusions: ECPR patients who experienced cardiac arrest in the ICU and in acute care hospital beds had increased odds of mortality compared with other locations. Moving patients for ECPR cannulation was not associated with improved outcomes.

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来源期刊

Critical Care Medicine 医学-危重病医学

CiteScore

16.30

自引率

5.70%

发文量

728

审稿时长

2 months

期刊介绍： Critical Care Medicine is the premier peer-reviewed, scientific publication in critical care medicine. Directed to those specialists who treat patients in the ICU and CCU, including chest physicians, surgeons, pediatricians, pharmacists/pharmacologists, anesthesiologists, critical care nurses, and other healthcare professionals, Critical Care Medicine covers all aspects of acute and emergency care for the critically ill or injured patient. Each issue presents critical care practitioners with clinical breakthroughs that lead to better patient care, the latest news on promising research, and advances in equipment and techniques.