SURVIVAL AFTER CARDIOPULMONARY RESUSCITATION IN THE HOSPITAL
SURVIVAL AFTER CARDIOPULMONARY RESUSCITATION IN THE HOSPITAL
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DOI：
10.1056/nejm198309083091001
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发表时间：
1983-01-01
影响因子：
158.5
通讯作者：
EPSTEIN, FH
中科院分区：
文献类型：
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作者：
BEDELL, SE;DELBANCO, TL;EPSTEIN, FH
我们对院内心肺复苏后决定预后的预后因素知之甚少。对294例在某大学附属医院连续复苏的患者进行了研究。41例患者（14%）出院；6个月后，其中3/4的人仍然活着。多因素分析显示，肺炎、低血压、肾衰竭、癌症和住院前居家生活方式与住院死亡率显著相关（P < 0.05）。58例肺炎患者和179例复苏时间超过30分钟的患者无一存活出院。另一方面，在复苏后存活24小时的患者中，有整整42%的人离开了医院。出院时和6个月后，93%的幸存者精神完好。虽然抑郁通常在出院时出现，但随后倾向于消退。然而，所有患者都报告了一些功能能力的下降，通常归因于恐惧。这种情况持续到出院后6小时。年龄本身似乎并不影响心肺复苏后的生存预后或出院后对慢性疾病的适应。
Little is known about prognostic factors that determine outcomes after in-hospital cardiopulmonary resuscitation. Consecutive patients (294) who were resuscitated in a university teaching hospital were studied. Forty one patients (14%) were discharged from the hospital; 3/4 of them were still alive 6 mo. later. A multivariate analysis revealed that pneumonia, hypotension, renal failure, cancer and a home-bound life style before hospitalization were significantly associated with in-hospital mortality (P < 0.05). None of the 58 patients with pneumonia and none of the 179 in whom resuscitation took longer than 30 min survived to be discharged. On the other hand, fully 42% of the patients who survived for 24 h after resuscitation left the hospital. At the time of discharge from the hospital and again 6 mo. later, 93% of the survivors were mentally intact. Although depression was generally present at the time of discharge, it tended to resolve subsequently. However, all patients reported some decrease in functional capacity, often attributed to fear. This persisted at 6 mo. after discharge. Age alone did not appear to influence the prognosis for survival after cardiopulmonary resuscitation or the adjustment to chronic illness after discharge from the hospital.