Mode of death after admission to an intensive care unit following cardiac arrest
Mode of death after admission to an intensive care unit following cardiac arrest
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DOI：
10.1007/s00134-004-2425-z
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发表时间：
2004-11-01
影响因子：
38.9
通讯作者：
Nolan, J
中科院分区：
文献类型：
--
作者：
Laver, S;Farrow, C;Nolan, J
目的：确定心脏骤停后入住重症监护病房 (ICU) 且出院前死亡的患者的死亡方式。设计：对数据库以及个体患者病历和 ICU 图表进行前瞻性定义的回顾性审查。环境：英国一家综合医院的 11 个床位的多学科重症监护室。患者和参与者：所有在 1998 年 2 月至 2003 年 7 月期间心脏骤停后 24 小时内入住 ICU 的患者。测量和结果：记录非幸存者的出院结果和死亡方式。根据死亡方式，非幸存者被分为三组之一：多器官衰竭死亡、神经系统死亡或心血管死亡。 205 名患者因心脏骤停被送入 ICU；院外心脏骤停后有 113 例（55.1%），院内心脏骤停后有 92 例（44.9%）。 126 例 (61.5%) 患者在出院前死亡，其中 58 例 (46.0%) 死于神经损伤。心脏骤停后，无论原发性心脏骤停心律失常如何，22.9%的住院患者和67.7%的院外患者因神经损伤而死亡。结论：院外心脏骤停后死亡的患者中有三分之二死于神经损伤，这一比例与心室颤动/室性心动过速和无脉性电活动/心搏停止的比例大致相同。院内心脏骤停后死亡的患者中，约有四分之一因神经损伤而死亡。
Objective: To determine the mode of death in patients admitted to an intensive care unit (ICU) after cardiac arrest who died before hospital discharge. Design: Prospectively defined retrospective review of a database and individual patient medical records and ICU charts. Setting: Eleven-bed multidisciplinary intensive care unit in a general hospital in the United Kingdom. Patients and participants: All patients admitted to ICU between February 1998 and July 2003 after a cardiac arrest in the previous 24 h. Measurements and results: The outcome at hospital discharge and mode of death in non-survivors were recorded. Based on the mode of death, non-survivors were placed in one of three groups: multiple organ failure death, neurological death or cardiovascular death. Two hundred and five patients were admitted to ICU after a cardiac arrest; 113 (55.1%) after out-of-hospital cardiac arrest and 92 (44.9%) after in-hospital cardiac arrest. One hundred and twenty-six (61.5%) patients died before hospital discharge and of these 58 (46.0%) died due to neurological injury. After cardiac arrest, 22.9% of the in-hospital patients and 67.7% of the out-of-hospital patients died due to neurological injury, irrespective of the primary cardiac arrest arrhythmia. Conclusions: Two-thirds of the patients dying after out-of-hospital cardiac arrest died due to neurological injury and this proportion was approximately the same for ventricular fibrillation/ventricular tachycardia and pulseless electrical activity/asystole. Approximately a quarter of the patients dying after in-hospital cardiac arrest died due to neurological injury.