In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study.
In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study.
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DOI：
10.1136/bmj.m3513
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发表时间：
2020-09-30
期刊：
影响因子：
--
通讯作者：
STOP-COVID Investigators
中科院分区：
文献类型：
--
作者：
Hayek SS;Brenner SK;Azam TU;Shadid HR;Anderson E;Berlin H;Pan M;Meloche C;Feroz R;O'Hayer P;Kaakati R;Bitar A;Padalia K;Perry D;Blakely P;Gupta S;Shaefi S;Srivastava A;Charytan DM;Bansal A;Mallappallil M;Melamed ML;Shehata AM;Sunderram J;Mathews KS;Sutherland AK;Nallamothu BK;Leaf DE;STOP-COVID Investigators
评估患有 2019 年冠状病毒病 (covid-19) 的危重成人中与院内心脏骤停和心肺复苏相关的发病率、危险因素和结果。多中心队列研究。美国各地 68 家医院设有重症监护病房。实验室确诊的 covid-19 危重成人（年龄 ≥ 18 岁）。进入重症监护病房后 14 天内院内心脏骤停和院内死亡率。在5019名covid-19重症患者中，14.0%（701/5019）出现院内心脏骤停，其中57.1%（400/701）接受了心肺复苏。与没有发生院内心脏骤停的患者相比，发生院内心脏骤停的患者年龄较大（平均年龄 63（标准差 14）v 60（15）岁），有更多合并症，并且更有可能入住重症监护病房床位较少的医院。接受心肺复苏的患者比未接受心肺复苏的患者更年轻（平均年龄 61（标准差 14）vs 67（14）岁）。心肺复苏时最常见的节律是无脉电活动（49.8%，199/400）和心搏停止（23.8%，95/400）。接受心肺复苏的 400 名患者中有 48 名 (12.0%) 存活出院，只有 7.0% (28/400) 存活出院时神经状态正常或轻度受损。出院存活率因年龄而异，45 岁以下患者的存活率为 21.2% (11/52)，而 80 岁或以上患者的存活率为 2.9% (1/34)。心脏骤停在 covid-19 危重患者中很常见，并且与生存率低有关，尤其是老年患者。
To estimate the incidence, risk factors, and outcomes associated with in-hospital cardiac arrest and cardiopulmonary resuscitation in critically ill adults with coronavirus disease 2019 (covid-19). Multicenter cohort study. Intensive care units at 68 geographically diverse hospitals across the United States. Critically ill adults (age ≥18 years) with laboratory confirmed covid-19. In-hospital cardiac arrest within 14 days of admission to an intensive care unit and in-hospital mortality. Among 5019 critically ill patients with covid-19, 14.0% (701/5019) had in-hospital cardiac arrest, 57.1% (400/701) of whom received cardiopulmonary resuscitation. Patients who had in-hospital cardiac arrest were older (mean age 63 (standard deviation 14) v 60 (15) years), had more comorbidities, and were more likely to be admitted to a hospital with a smaller number of intensive care unit beds compared with those who did not have in-hospital cardiac arrest. Patients who received cardiopulmonary resuscitation were younger than those who did not (mean age 61 (standard deviation 14) v 67 (14) years). The most common rhythms at the time of cardiopulmonary resuscitation were pulseless electrical activity (49.8%, 199/400) and asystole (23.8%, 95/400). 48 of the 400 patients (12.0%) who received cardiopulmonary resuscitation survived to hospital discharge, and only 7.0% (28/400) survived to hospital discharge with normal or mildly impaired neurological status. Survival to hospital discharge differed by age, with 21.2% (11/52) of patients younger than 45 years surviving compared with 2.9% (1/34) of those aged 80 or older. Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among older patients.
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发表时间：
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