Ischemic Heart Disease Diagnosed Before Sudden Cardiac Arrest Is Independently Associated With Improved Survival
Ischemic Heart Disease Diagnosed Before Sudden Cardiac Arrest Is Independently Associated With Improved Survival
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DOI：
10.1161/jaha.114.001160
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发表时间：
2014-10-01
影响因子：
5.4
通讯作者：
Chugh, Sumeet S.
中科院分区：
文献类型：
--
作者：
Stecker, Eric C.;Teodorescu, Carmen;Chugh, Sumeet S.
心脏骤停（SCA）是一个重要的公共卫生问题，复苏后的存活率仍远低于10%。虽然几个复苏相关的因素始终与SCA的生存，具体的共病条件的影响尚未assessed.Methods和结果的俄勒冈州突然意外的研究是一个正在进行的，多学科，以社区为基础的研究在波特兰，俄勒冈州。在2002年至2012年期间接受过尝试复苏的SCA患者，如果有可用的心脏骤停和心脏骤停前医疗记录，则纳入本分析。来自紧急医疗服务系统、体检医师、公共卫生部门、医院和诊所的信息用于判定SCA、评估合并症和确定药物治疗。进行单变量和多变量分析，以研究心脏骤停前合并症对出院生存率的影响。在纳入的1466例患者中，已建立的复苏相关预测因子（Utstein因子）与生存率相关，与既往报告一致。当一组心脏骤停前合并症与Utstein因子一起进行沿着评估时，确诊的冠状动脉疾病与高生存率显著相关（未校正比值比1.5，P
Background-Sudden cardiac arrest (SCA) is a significant public health problem, and rates of survival after resuscitation remain well below 10%. While several resuscitation-related factors are consistently associated with survival from SCA, the impact of specific comorbid conditions has not been assessed.Methods and Results-The Oregon Sudden Unexpected Study is an ongoing, multisource, community-based study in Portland, Oregon. Patients with SCA who underwent attempted resuscitation between 2002 and 2012 were included in this analysis if there were both arrest and prearrest medical records available. Information from the emergency medical services system, medical examiner, public health division, hospitals, and clinics was used to adjudicate SCA, evaluate comorbidities, and identify medical treatments. Univariate and multivariate analyses were performed to investigate the influence of prearrest comorbidities on survival to hospital discharge. Among 1466 included patients, established resuscitation-related predictors (Utstein factors) were associated with survival, consistent with prior reports. When a panel of prearrest comorbidities was evaluated along with Utstein factors, recognized coronary artery disease was significantly associated and predicted higher odds of survival (unadjusted odds ratio 1.5, P