老年人院外心搏骤停的相关因素及预后分析

发布时间：2018-01-16 00:04

本文关键词：老年人院外心搏骤停的相关因素及预后分析　出处：《中华老年心脑血管病杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的分析老年人院外心搏骤停(OHCA)的流行病学特征,探讨影响老年人OHCA预后的相关因素。方法参照Utstein模式收集2012年1月~2016年10月浙江省人民医院急诊科、绍兴市急救中心和宁波市急救中心接诊的625例OHCA患者,根据年龄分为老年组326例和中青年组299例,回顾性分析患者临床资料。比较2组流行病学特征及预后差异,并进行回归分析。结果与中青年组比较,老年组患者发作地点在家里比例更高(79.1%vs47.5%),初始心律表现为不可电击心律(89.9%vs 84.6%)和发病原因为心源性(52.5%vs 44.5%)及被目击比例(77.6%vs 70.6%)更高(P0.05,P0.01)。老年组在现场/途中自主循环恢复(ROSC)、急诊室ROSC、存活住院及存活出院比例均明显低于中青年组(P0.05,P0.01)。初始心律为可电击心律、急救反应时间10min、旁观者心肺复苏及院外除颤是老年OHCA患者出现ROSC的独立预测因素。结论老年OHCA在发作地点、初始心律、病因及被目击等上有特点;预后较中青年OHCA差;完善相关急救措施可能增加ROSC率。
[Abstract]:Objective to analyze the epidemiological characteristics of OHCA in elderly patients with cardiac arrest outside hospital. Methods according to the Utstein model, we collected the emergency department of Zhejiang Provincial people's Hospital from January 2012 to October 2016. According to the age, 625 OHCA patients received treatment in Shaoxing first aid center and Ningbo emergency center were divided into elderly group (326 cases) and middle and young group (299 cases). The clinical data of the patients were analyzed retrospectively. The epidemiological characteristics and prognosis of the two groups were compared, and the results were compared with those of the young and middle-aged groups. The incidence of attack in the elderly group was higher than that in the home (79.1% vs 47.5%). The initial arrhythmias presented as non-electric arrhythmias (89.9 vs 84.6) and the causes of the disease were cardiogenic 52.5 vs 44.5) and the proportion of witnesses (. 77.6% vs 70.6% (P 0.05). P0.010.The recovery rate of roscus, emergency room, survival hospitalization and survival discharge in the elderly group was significantly lower than that in the young and middle-aged group (P0.05). The initial rhythm was electroshock rhythm and the first aid reaction time was 10 min. Bystander cardiopulmonary resuscitation and defibrillation were independent predictors of ROSC in elderly patients with OHCA. Conclusion elderly OHCA is characterized by its location, initial rhythm, etiology and sightings. The prognosis was worse than that of young and middle-aged OHCA. The improvement of emergency measures may increase the rate of ROSC.
【作者单位】：浙江省人民医院急诊科;绍兴市急救中心;宁波市急救中心;
【分类号】：R459.7
【正文快照】： 院外心搏骤停(out-of-hospital cardiac arrest,OHCA)已成为全球性的健康问题,在美国、欧洲和日本每年分别约有30万、28万和10万例OHCA发作[1-3]。OHCA的病死率极高,据一项关于复苏成功率的荟萃分析显示,最终仅有约7.6%的患者能存活出院[4]。OHCA发病率随着年龄增长显著增加,O

【相似文献】