Analysis of factors associated with survival to hospital discharge in emergency adult extracorporeal cardiopulmonary resuscitation patients
10.3760/cma.j.issn.1671-0282.2024.12.013
- VernacularTitle:急诊成人体外心肺复苏患者出院存活相关因素分析
- Author:
Pengyuan CHEN
1
;
Xiaoyue YAO
;
Minfei YANG
;
Guangju ZHOU
;
Jintao WEI
;
Cheng ZHENG
;
Quanneng HUANG
;
Jiani XU
;
Ke QIAN
Author Information
1. 浙江大学医学院附属第二医院护理部，杭州 310009
- Keywords:
Cardiacarrest Extracorporeal Cardiopulmonary Resuscitation;
Emergency;
Survive;
Intra-Aortic Balloon Pump
- From:
Chinese Journal of Emergency Medicine
2024;33(12):1738-1742
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical features of out-of-hospital extracorporeal cardiopulmonary resuscitation(ECPR) patients and analyze the factors associated with discharge survival.Methods:The data of 54 patients with ECPR in the Emergency Center of the Second Hospital Affiliated to Zhejiang University School of Medicine from January 2020 to December 2023 were analyzed. Patients were divided into the survival group and death group based on their survival status within 30 days of discharge. Kaplan Meier method was used to draw the survival curve, and COX regression analysis was used to analyze the relevant factors of survival.Results:(1) A total of 54 patients with ECPR were included in this study. 17 (31.5%) cases were discharged alive, of which 10 (58.8%) had a good neurological prognosis, while 37 case (68.5%) died.(2) Kaplan-Meier survival analysis showed that patients who received first-witness CPR, had a lower-extremity perfusion line established, underwent IABP, achieved ROSC, had normal pH, and had an initial pupillary light reflex had a longer median survival time ( P < 0.05). (3) Univariate COX regression analysis showed that statistically differences in survival time among patients with ECMO times, hypoperfusion times, initial pupil sizes, and APACHEⅡ scores ( P < 0.05); (4) Multivariate COX regression analysis showed that APACHEⅡ score, initial pupil size, and IABP were independent predictors of survival of patients discharged from the hospital with emergency ECPR; (5) The concordance index of the COX regression model was 0.921. Conclusions:The survival model demonstrates good predictive accuracy. Healthcare professionals can use the APACHEⅡscore and initial pupil size on admission as important reference indicators to assist in determining patient prognosis, and to timely initiate IABP treatment, in conjunction with the patient’s condition, to improve the survival rate of patients discharged from the hospital.
