Clinical characteristics of in-hospital cardiac arrest in emergency patients in Kashgar area and analysis of influencing factors on success rate of cardiopulmonary resuscitation.
10.3760/cma.j.cn121430-20230131-00054
- Author:
Yi LONG
1
;
Xiaojiang LI
2
;
Yu LIANG
3
;
Tuerxun MAIMAITIAILI
2
;
Aili MAIHEMUTI
4
;
Min DENG
2
;
Xingzhou WU
5
;
Guixiang LIU
6
;
Youwu QUAN
7
;
Jinhong YANG
8
;
Junhua HAN
9
;
Tulafu REYIHANGULI
10
;
Chunfu ZHANG
2
Author Information
1. Department of Intensive Care Unit, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, Guangdong, China.
2. Emergency Intensive Care Unit, the First People's Hospital of Kashgar Prefecture, Kashgar 844000, Xinjiang Uygur Autonomous Region, China.
3. Chest Pain Center, the First People's Hospital of Kashgar Prefecture, Kashgar 844000, Xinjiang Uygur Autonomous Region, China.
4. Department of Emergency Medicine, the First People's Hospital of Kashgar Prefecture, Kashgar 844000, Xinjiang Uygur Autonomous Region, China.
5. Department of Emergency, Kashgar People's Hospital, Kashgar 844000, Xinjiang Uygur Autonomous Region, China.
6. Department of Critical Care Medicine, Yuepuhu County People's Hospital, Kashgar 844000, Xinjiang Uygur Autonomous Region, China.
7. Department of Emergency Medicine, Bachu County People's Hospital, Kashgar 844000, Xinjiang Uygur Autonomous Region, China.
8. Department of Emergency, Yingjisha County People's Hospital, Kashgar 844000, Xinjiang Uygur Autonomous Region, China.
9. Intensive Care Unit, Maigaiti County People's Hospital, Kashgar 844000, Xinjiang Uygur Autonomous Region, China.
10. Department of Critical Care Medicine, Shufu County People's Hospital, Kashgar 844000, Xinjiang Uygur Autonomous Region, China. Corresponding author: Li Xiaojiang, Email: longyi20100@163.com.
- Publication Type:Journal Article
- MeSH:
Humans;
Adult;
Middle Aged;
Aged;
Retrospective Studies;
Cardiopulmonary Resuscitation;
Heart Arrest/therapy*;
Electric Countershock;
Hospitals
- From:
Chinese Critical Care Medicine
2023;35(7):719-723
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To analyze the clinical characteristics of patients with emergency in-hospital cardiac arrest (IHCA) in Kashgar, Xinjiang Uygur Autonomous Region and the factors affecting the success rate of cardiopulmonary resuscitation.
METHODS:Retrospectively selected patients who had cardiac arrest and cardiopulmonary resuscitation in the emergency department of the People's Hospital of 6 counties and cities in Kashgar area from January 2019 to January 2022. The clinical data of all patients were collected, including gender, age, major underlying diseases, the beginning and duration of resuscitation, the number of electric defibrillation acute physiology and chronic health evaluation II (APACHE II). According to whether the resuscitation was successful, all patients were divided into successful resuscitation group and failed resuscitation group. The clinical characteristics of the two groups were compared. Then, the influencing factors of the success rate of cardiopulmonary resuscitation in IHCA patients were analyzed by binary Logistic regression.
RESULTS:A total of 1 376 patients were enrolled, including 1 117 cases of failed resuscitation and 259 cases of successful resuscitation. The success rate of resuscitation was 18.82%. Compared with the resuscitation failure group, the patients in the successful resuscitation group were younger (age: 49.10±20.99 vs. 58.44±18.32), the resuscitation start time was earlier [resuscitation start time ≤ 5 minutes: 76.45% (198/259) vs. 66.61% (744/1 117)], the proportion of cardiovascular and cerebrovascular diseases was lower [cardiovascular disease: 49.42% (128/259) vs. 58.19% (650/1 117), cerebrovascular disease: 17.37% (45/259) vs. 21.58% (241/1 117)], the number of electric defibrillation was lower [times: 0 (0, 2) vs. 1 (0, 1)], the proportion of endotracheal intubation was more [80.31% (208/259) vs. 55.60% (621/1 117)], APACHE II score was lower (13.75±8.03 vs. 17.90±4.63), and the difference was statistically significant (all P < 0.01). Binary Logistic regression analysis showed that age, start time of resuscitation, ventilation mode and APACHE II score were protective factors affecting the success rate of cardiopulmonary resuscitation in patients with emergency IHCA [age: odds ratio (OR) = 0.982, 95% confidence interval (95%CI) was 0.973-0.991, P < 0.001; resuscitation start time ≤ 5 minutes: OR = 0.629, 95%CI was 0.409-0.966, P = 0.034; tracheal intubation assisted ventilation: OR = 0.243, 95%CI was 0.149-0.397, P < 0.001; low APACHE II score: OR = 0.871, 95%CI was 0.836-0.907, P < 0.001], while underlying diseases (cardiovascular diseases) are a risk factor affecting the success rate of cardiopulmonary resuscitation (OR = 1.190, 95%CI was 1.015-1.395, P = 0.036).
CONCLUSIONS:Age, resuscitation start time, ventilation mode, APACHE II score and major underlying diseases (cardiovascular diseases) have a greater impact on the success rate of resuscitation in IHCA patients. The above factors are conducive to improving or formulating more effective rescue strategies for IHCA patients, so as to achieve the purpose of improving the success rate of clinical treatment.
