A history of smoking is associated with improved survival in patients treated with mild therapeutic hypothermia following cardiac arrest.
A history of smoking is associated with improved survival in patients treated with mild therapeutic hypothermia following cardiac arrest.
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DOI：
10.1016/j.resuscitation.2013.08.275
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发表时间：
2014-01
期刊：
影响因子：
6.5
通讯作者：
McPherson JA
中科院分区：
文献类型：
--
作者：
Pollock JS;Hollenbeck RD;Wang L;Janz DR;Rice TW;McPherson JA
评估吸烟与心脏骤停患者接受轻度低温治疗（TH）后神经功能预后良好的生存率之间的关系。我们对2007年5月至2012年1月期间接受TH治疗的188例心脏骤停患者进行了回顾性观察研究。通过病历审查回顾性收集吸烟状态，并将其分类为“曾经”或“从未”。主要终点是出院时的生存率，并在吸烟者和非吸烟者之间进行比较。Logistic回归分析用于评估出院时吸烟状态与神经功能结局之间的相关性;调整年龄、初始心律、自主循环恢复时间（ROSC）、旁观者CPR和TH启动时间。与非吸烟者相比，吸烟者更有可能存活至出院，神经功能结局良好（50% vs. 28%，p = 0.003）。在调整年龄、初始心律、ROSC时间、旁观者CPR和TH开始时间后，吸烟史与出院时神经功能结局良好的生存率增加相关（OR 3.54，95%CI 1.41-8.84，p = 0.007）。吸烟与心脏骤停患者的生存率提高和神经功能预后良好相关。我们假设我们的研究结果反映了吸烟引起的全身缺血性条件反射。
To assess the association between smoking and survival with a good neurologic outcome in patients following cardiac arrest treated with mild therapeutic hypothermia (TH). We conducted a retrospective observational study of a prospectively collected cohort of 188 consecutive patients following cardiac arrest treated with TH between May 2007 and January 2012. Smoking status was retrospectively collected via chart review and was classified as “ever” or “never”. Primary endpoint was survival to hospital discharge with a good neurologic outcome and was compared between smokers and nonsmokers. Logistic regression analysis was used to assess the association between smoking status and neurologic outcome at hospital discharge; adjusting for age, initial rhythm, time to return of spontaneous circulation (ROSC), bystander CPR, and time to initiation of TH. Smokers were significantly more likely to survive to hospital discharge with good neurologic outcome compared to nonsmokers (50% vs. 28%, p = 0.003). After adjusting for age, initial rhythm, time to ROSC, bystander CPR, and time to initiation of TH, a history of smoking was associated with increased odds of survival to hospital discharge with good neurologic outcome (OR 3.54, 95% CI 1.41–8.84, p = 0.007). Smoking is associated with improved survival with good neurologic outcome in patients following cardiac arrest. We hypothesize that our findings reflect global ischemic conditioning caused by smoking.