Outcomes Following In-Hospital Cardiopulmonary Resuscitation in People Receiving Maintenance Dialysis.
Outcomes Following In-Hospital Cardiopulmonary Resuscitation in People Receiving Maintenance Dialysis.
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DOI：
10.1016/j.xkme.2021.08.014
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发表时间：
2022-01
期刊：
影响因子：
3.9
通讯作者：
Fiscella KA
中科院分区：
文献类型：
--
作者：
Saeed F;Murad HF;Wing RE;Li J;Schold JD;Fiscella KA
先前显示透析人群心肺复苏（CPR）结局较差的研究主要来自索赔数据，并且由于缺乏CPR事件的详细表征而受到一定限制。我们旨在分析接受维持性透析的个体的CPR相关结局。回顾性病历审查。使用来自单一学术医疗保健系统的电子病历，我们确定了2006年至2014年期间接受维持性透析的所有住院成人患者，这些患者接受了院内CPR。初步院内心肺复苏总生存率，心肺复苏术失败的预测因子，首次存活者在同一住院期间死亡的预测因子，出院回家状态的预测因子。我们提供了研究变量的描述性统计量，并使用t检验、χ2检验或Fisher精确检验来比较组间差异。我们建立了多变量逻辑回归模型来检验CPR相关的结果。共有184例患者接受了院内CPR：51例（28%）在最初的CPR事件中没有存活，77例CPR幸存者在同一住院期间死亡（额外42%）（总死亡率70%）。只有18例（10%）出院回家，其余32例（17%）出院到康复机构或疗养院。在多变量模型中，CPR持续时间是CPR失败的唯一预测因素（OR，1.41; 95%CI，1.24-1.61; P < 0.001）。在首次CPR事件后同一住院期间死亡的预测因素是CPR持续时间（OR，1.15; 95%CI，1.04-1.27; P = 0.007）和年龄较大（OR，1.64; 95%CI，1.23-2.2; P < 0.001）。老年人出院回家的几率也较低（OR，0.25; 95%CI，0.11-0.54; P < 0.001）。回顾性研究设计，单中心研究，无功能状态信息。接受维持性透析的患者在院内CPR后死亡率很高，只有10%的患者出院回家。这些数据可以帮助临床医生提供有用的预后信息，同时参与护理对话的目标。
Previous studies showing poor cardiopulmonary resuscitation (CPR) outcomes in the dialysis population have largely been derived from claims data and are somewhat limited by a lack of detailed characterization of CPR events. We aimed to analyze CPR-related outcomes in individuals receiving maintenance dialysis. Retrospective chart review. Using electronic medical records from a single academic health care system, we identified all hospitalized adult patients receiving maintenance dialysis who had undergone in-hospital CPR between 2006 and 2014. Initial in-hospital CPR. Overall survival, predictors of unsuccessful CPR, predictors of death during the same hospitalization among initial survivors, predictors of discharge-to-home status. We provide descriptive statistics for the study variables and used t tests, χ2 tests, or Fisher exact tests to compare differences between the groups. We built multivariable logistic regression models to examine the CPR-related outcomes. A total of 184 patients received in-hospital CPR: 51 (28%) did not survive the initial CPR event, and 77 CPR survivors died (additional 42%) later during the same hospitalization (overall mortality 70%). Only 18 (10%) were discharged home, with the remaining 32 (17%) discharged to a rehabilitation facility or a nursing home. In the multivariable model, the only predictor of unsuccessful CPR was CPR duration (OR, 1.41; 95% CI, 1.24-1.61; P < 0.001). Predictors of death during the same hospitalization after surviving the initial CPR event were CPR duration (OR, 1.15; 95% CI 1.04-1.27; P = 0.007) and older age (OR, 1.64; 95% CI, 1.23-2.2; P < 0.001). Older people also had lower odds of discharge-to-home status (OR, 0.25; 95% CI, 0.11-0.54; P < 0.001). Retrospective study design, single-center study, no information on functional status. Patients receiving maintenance dialysis experience high mortality following in-hospital CPR and only 10% are discharged home. These data may help clinicians provide useful prognostic information while engaging in goals of care conversations.
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影响因子：
24
作者：
Ofoma UR;Basnet S;Berger A;Kirchner HL;Girotra S;American Heart Association Get With the Guidelines – Resuscitation Investigators
通讯作者：
American Heart Association Get With the Guidelines – Resuscitation Investigators
DOI：
10.1016/j.apmr.2012.02.032
发表时间：
2012-08-01
影响因子：
4.3
作者：
Qureshi, Adnan I.;Chaudhry, Saqib A.;Suri, M. Fareed K.
通讯作者：
Suri, M. Fareed K.
影响因子：
13.6
作者：
Saeed, Fahad;Adil, Malik M.;Holley, Jean L.
通讯作者：
Holley, Jean L.
DOI：
10.2215/cjn.07530715
发表时间：
2016-10-01
影响因子：
9.8
作者：
Saeed, Fahad;Adil, Malik M.;Nally, Joseph V., Jr.
通讯作者：
Nally, Joseph V., Jr.
影响因子：
4.2
作者：
Saeed, Fahad;Duberstein, Paul R.;Epstein, Ronald M.;Lang, Valerie J.;Liebman, Scott E.
通讯作者：
Liebman, Scott E.