Early prognostic impact of serum sodium level among out-of-hospital cardiac arrest patients: a nationwide multicentre observational study in Japan (the JAAM-OHCA registry)
Early prognostic impact of serum sodium level among out-of-hospital cardiac arrest patients: a nationwide multicentre observational study in Japan (the JAAM-OHCA registry)
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院外心脏骤停患者血清钠水平的早期预后影响：日本全国性多中心观察性研究（JAAM-OHCA 注册中心）
DOI：
10.1007/s00380-022-02020-3
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发表时间：
2022
影响因子：
1.5
通讯作者：
et al.
中科院分区：
文献类型：
--
作者：
Shida Haruka;Kitamura Tetsuhisa;et al.
钠血症是一种电解质紊乱，通常与各种疾病的死亡率有关。然而，对院外心脏骤停（OHCA）病例中的钠血症知之甚少。在这里，我们调查了到达医院时血清钠水平与OHCA后神经系统预后之间的关系。这项以医院为基础的全国性观察性研究（日本急性医学协会院外心脏骤停登记处）在2014年至2017年期间招募了OHCA患者。我们纳入了年龄≥18岁的非外伤性OHCA患者，这些患者实现了自发循环（ROSC）的恢复，并且到达医院时血清钠水平是可用的。根据血清钠水平，将患者分为低钠血症（Na < 135 mEq/L）、正常钠血症（Na≥135或≤145 mEq/L）和高钠血症（Na bb0 145 mEq/L）三个水平。主要结局是1个月的生存，神经系统预后良好。共有34754例OHCA患者被记录在案，5160例非创伤性OHCA并达到ROSC的患者符合我们的分析。在钠水平正常的患者中，神经系统预后良好的比例最高，为17.6%(677/3854)，其次是低钠血症患者，为8.2%(57/696)，高钠血症患者为5.7%（35/610）。此外，与正常钠水平相比，低钠血症和高钠血症与神经系统预后良好的概率降低相关（与低钠血症相比，调整优势比[AOR] 0.97, 95%可信区间[CI] 0.95-0.99；与高钠血症相比，调整优势比[AOR] 0.96, 95%可信区间[CI] 0.94-0.98）。入院时低钠血症和高钠血症与实现ROSC的非创伤性OHCA患者良好神经预后的可能性降低有关。
Dysnatremia is an electrolytic disorder commonly associated with mortality in various diseases. However, little is known about dysnatremia in out-of-hospital cardiac arrest (OHCA) cases. Here, we investigated the association between serum sodium level on hospital arrival and neurological outcomes after OHCA. This nationwide hospital-based observational study (The Japanese Association for Acute Medicine Out-of-Hospital Cardiac Arrest registry) enrolled patients with OHCA between 2014 and 2017. We included adult patients aged ≥ 18 years with non-traumatic OHCA who achieved return of spontaneous circulation (ROSC) and whose serum sodium level on hospital arrival was available. Based on the serum sodium level, patients were divided into three levels: hyponatremia (Na < 135 mEq/L), normal sodium level (Na ≥ 135 or ≤ 145 mEq/L), and hypernatremia (Na > 145 mEq/L). The primary outcome was 1-month survival with favourable neurological outcomes. Altogether, 34 754 patients with OHCA were documented, and 5160 patients with non-traumatic OHCA and who achieved ROSC were eligible for our analyses. The proportion of favourable neurological outcomes was highest in patients with normal sodium levels at 17.6% (677/3854), followed by patients with hyponatremia at 8.2% (57/696) and patients with hypernatremia at 5.7% (35/610). Moreover, hyponatremia and hypernatremia were associated with a decreased probability of favourable neurological outcomes compared with normal sodium level (vs. hyponatremia, adjusted odds ratio [AOR] 0.97, 95% confidence interval [CI] 0.95–0.99; vs. hypernatremia, AOR 0.96, 95% CI 0.94–0.98). Hypo- and hypernatremia on hospital arrival were associated with a decreased probability of favourable neurological outcomes in patients with non-traumatic OHCA who achieved ROSC.
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影响因子：
3.6
作者：
Giordano, Mauro;Ciarambino, Tiziana;Adinolfi, Luigi Elio
通讯作者：
Adinolfi, Luigi Elio
影响因子：
1.5
作者：
Asano, Mitsutoshi;Kurabayashi, Manabu;Sasano, Tetsuo
通讯作者：
Sasano, Tetsuo
影响因子：
3.7
作者：
Ma QQ;Fan XD;Li T;Hao YY;Ma F
通讯作者：
Ma F
影响因子：
8.8
作者：
Hayashida, Kei;Suzuki, Masaru;Morimura, Naoto
通讯作者：
Morimura, Naoto
DOI：
10.1056/nejmoa0801209
发表时间：
2008-09-04
期刊：
The New England journal of medicine
影响因子：
--
作者：
Kim WR;Biggins SW;Kremers WK;Wiesner RH;Kamath PS;Benson JT;Edwards E;Therneau TM
通讯作者：
Therneau TM