Risk factors for poor prognosis in patients with extracorporeal cardiopulmonary resuscitation
10.3760/cma.j.issn.1671-0282.2024.02.013
- VernacularTitle:体外心肺复苏患者预后不良的危险因素
- Author:
Junjun WANG
1
;
Shuai TONG
;
Ruyi LEI
;
Xinya JIA
;
Xiaodong SONG
;
Tangjuan ZHANG
;
Hong WANG
;
Yan ZHOU
;
Renjie LI
;
Xingqiang ZHU
;
Chujun YANG
;
Chao LAN
Author Information
1. 郑州大学第一附属医院急诊科，郑州 450000
- Keywords:
Cardiac arrest;
Cardiopulmonary resuscitation;
Extracorporeal membrane oxygenation;
External cardiopulmonary resuscitation;
Lactate;
Shockable rhythm;
Seque
- From:
Chinese Journal of Emergency Medicine
2024;33(2):215-221
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR), and to explore the risk factors leading to poor prognosis.Methods:The clinical data of 95 patients with ECPR admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to May 2023 were retrospectively analyzed. According to the survival status at the time of discharge, the patients were divided into the survival group and death group. The difference of clinical data between the two groups was compared to explore the risk factors related to death and poor prognosis. Risk factors associated with death were identified by Binary Logistic regression analysis. Results:A total of 95 patients with ECPR were included in this study, 62 (65.3%) died and 33 (34.7%) survived at discharge. Patients in the death group had longer low blood flow time [40 (30, 52.5) min vs. 30 (24.5, 40) min ] and total cardiac arrest time[40 (30, 52.5) min vs. 30(24.5, 40) min], shorter total hospital stay [3 (2, 7.25) d vs. 19 (13.5, 31) d] and extracorporeal membrane oxygenation (ECMO) assisted time [26.5 (17, 50) h vs. 62 (44, 80.5) h], and more IHCA patients (56.5% vs. 33.3%) and less had spontaneous rhythm recovery before ECMO (37.1% vs. 84.8%). Initial lactate value [(14.008 ± 5.188) mmol/L vs.(11.23 ± 4.718) mmol/L], APACHEⅡ score [(30.10 ± 7.45) vs. (25.88 ± 7.68)] and SOFA score [12 (10.75, 16) vs. 10 (9.5, 13)] were higher ( P< 0.05). Conclusions:No spontaneous rhythm recovery before ECMO, high initial lactic acid and high SOFA score are independent risk factors for poor prognosis in ECPR patients.
