Mortality after in-hospital cardiac arrest in patients with COVID-19: A systematic review and meta-analysis.
Mortality after in-hospital cardiac arrest in patients with COVID-19: A systematic review and meta-analysis.
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DOI：
10.1016/j.resuscitation.2021.04.025
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发表时间：
2021-07
期刊：
影响因子：
6.5
通讯作者：
Cortegiani A
中科院分区：
文献类型：
--
作者：
Ippolito M;Catalisano G;Marino C;Fucà R;Giarratano A;Baldi E;Einav S;Cortegiani A
估计COVID-19患者在院内心脏骤停（IHCA）和尝试心肺复苏（CPR）后的死亡率、自主循环恢复率（ROSC）和具有良好神经结局的生存率。PubMed、EMBASE、Web of Science、bioRxiv和medRxiv调查了截至2021年2月8日报告IHCA后COVID-19患者死亡率数据的研究。研究的主要结局是IHCA尝试CPR后的死亡率（住院或30天）。其他结局包括IHCA的总体发生率、非电击性呈现节律的发生率、ROSC的发生率和神经系统状态良好的生存率。系统性综述和荟萃分析纳入了10篇文章，共计1179例接受IHCA后尝试CPR的COVID-19患者。估计的总死亡率（住院或30天）为89.9%（95%预测区间[P.I.] 83.1%-94.2%; 1060/1179例患者; I2 = 82%）。非电击性呈现节律的估计率为89%（95% P. I. 82.8%-93.1%; 1022/1205例患者; I2 = 85%），ROSC估计率为32.9%（95%P.I. 26%-40.6%; 365/1205例患者; I2 = 82%）。30天时具有良好神经系统状态的估计总生存率为6.3%（95% P. I. 4%-9.7%; 50/851例患者; I2 = 48%）。敏感性分析显示，COVID-19患者在IHCA后的死亡风险高于非COVID-19患者（OR 2. 34; 95% C.I. 1.37 - 3.99;研究数量= 3; 1215例患者）。尽管三分之一接受IHCA的COVID-19患者可能达到ROSC，但几乎90%的患者可能无法存活30天或出院。
To estimate the mortality rate, the rate of return of spontaneous circulation (ROSC) and survival with favorable neurological outcome in patients with COVID-19 after in-hospital cardiac arrest (IHCA) and attempted cardiopulmonary resuscitation (CPR). PubMed, EMBASE, Web of Science, bioRxiv and medRxiv were surveyed up to 8th February 2021 for studies reporting data on mortality of patients with COVID-19 after IHCA. The primary outcome sought was mortality (in-hospital or at 30 days) after IHCA with attempted CPR. Additional outcomes were the overall rate of IHCA, the rate of non-shockable presenting rhythms, the rate of ROSC and the rate of survival with favorable neurological status. Ten articles were included in the systematic review and meta-analysis, for a total of 1179 COVID-19 patients after IHCA with attempted CPR. The estimated overall mortality rate (in-hospital or at 30 days) was 89.9% (95% Predicted Interval [P.I.] 83.1%–94.2%; 1060/1179 patients; I2 = 82%). The estimated rate of non-shockable presenting rhythms was 89% (95% P.I. 82.8%–93.1%; 1022/1205 patients; I2 = 85%), and the estimated rate of ROSC was 32.9% (95% P.I. 26%–40.6%; 365/1205 patients; I2 = 82%). The estimated overall rate of survival with favorable neurological status at 30 days was 6.3% (95% P.I. 4%–9.7%; 50/851 patients; I2 = 48%). Sensitivity analysis showed that COVID-19 patients had higher risk of death after IHCA than non COVID-19 patients (OR 2.34; 95% C.I. 1.37–3.99; number of studies = 3; 1215 patients). Although one of three COVID-19 patients undergoing IHCA may achieve ROSC, almost 90% may not survive at 30 days or to hospital discharge.
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作者：
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通讯作者：
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DOI：
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