Characteristics and Outcomes of Cardiac Arrest in Adult Patients Admitted to Pediatric Services: A Descriptive Analysis of the American Heart Association's Get With The Guidelines-Resuscitation Data.
Characteristics and Outcomes of Cardiac Arrest in Adult Patients Admitted to Pediatric Services: A Descriptive Analysis of the American Heart Association's Get With The Guidelines-Resuscitation Data.
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接受儿科服务的成年患者心脏骤停的特征和结果：对美国心脏协会的复苏指南数据的描述性分析。
DOI：
10.1097/pcc.0000000000003104
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
AmericanHeartAssociation’sGetWithTheGuidelines-ResuscitationInvestigators
中科院分区：
文献类型：
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作者：
O'Halloran,AmandaJ;Grossestreuer,AnneV;Balaji,Lakshman;Ross,CatherineE;Holmberg,MathiasJ;Donnino,MichaelW;Kleinman,MonicaE;AmericanHeartAssociation’sGetWithTheGuidelines-ResuscitationInvestigators
目的：成人和儿童院内心脏骤停(IHCA)之间的差异被很好地描述。虽然大多数成年人在成人服务中得到照顾，但儿科服务经常接纳成年人，特别是那些患有慢性病的人。这项研究的目的是描述接受儿科服务的成年人的IHCA。设计：来自美国心脏协会的GET与指南-复苏登记的回顾性队列分析，研究入院时患有IHCA的成人亚群。采用多变量Logistic回归来评估调整后的生存结果，并比较不同年龄组(18-21岁、22-25岁和≥26岁)之间的结果。设置：符合指南-复苏登记的医院对GET做出贡献的医院。患者：2000年至2018年在儿科服务住院时无脉搏IHCA的成年患者(≥18岁)。干预：无。测量和主要结果：在19年的回顾期间，在17个地点的儿科服务记录了491例成人IHCAs，这些事件占所有成人IHCAs的0.1%。总共有221例符合纳入标准，139个事件被排除在外，这些事件是由于心动过缓和血流灌注不良的初始节律。患者的平均年龄为22岁(四分位数范围为19-28岁)。98%的患者至少有一种先前存在的疾病。63%的患者自主循环恢复，30%的患者存活至出院。所有年龄组的存活率与出院的比率相似(范围26-37%；p=0.37)，在研究期间存活率没有变化(范围26-37%；调整后的存活率至出院的p=0.23)。结论：在这群因IHCA入院的成人中，我们未能发现生存结果与年龄之间的关系。为了更好地了解这一人群中的复苏，还需要进行更多的研究。
OBJECTIVES:Differences between adult and pediatric in-hospital cardiac arrest (IHCA) are well-described. Although most adults are cared for on adult services, pediatric services often admit adults, particularly those with chronic conditions. The objective of this study is to describe IHCA in adults admitted to pediatric services.DESIGN:Retrospective cohort analysis from the American Heart Association’s Get With The Guidelines-Resuscitation registry of a subpopulation of adults with IHCA while admitted to pediatric services. Multivariable logistic regression was used to evaluate adjusted survival outcomes and compare outcomes between age groups (18–21, 22–25, and≥ 26 yr old).SETTING:Hospitals contributing to the Get With The Guidelines-Resuscitation registry.PATIENTS:Adult-aged patients (≥ 18 yr) with an index pulseless IHCA while admitted to a pediatric service from 2000 to 2018.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:A total of 491 adult IHCAs were recorded on pediatric services at 17 sites, during the 19 years of review, and these events represented 0.1% of all adult IHCAs. In total, 221 cases met inclusion criteria with 139 events excluded due to an initial rhythm of bradycardia with poor perfusion. Median patient age was 22 years (interquartile range, 19–28 yr). Ninety-eight percent of patients had at least one pre-existing condition. Return of spontaneous circulation occurred in 63% of events and 30% of the patients survived to discharge. All age groups had similar rates of survival to discharge (range 26–37%; p= 0.37), and survival did not change over the study period (range 26–37%; p= 0.23 for adjusted survival to discharge).CONCLUSIONS:In this cohort of adults with IHCA while admitted to a pediatric service, we failed to find an association between survival outcomes and age. Additional research is needed to better understand resuscitation in this population.