بررسي عوامل موثر در موفقيت احياي قلبي- ريوي در بيماران با ايست قلبي- ريوي داخل بيمارستاني

Evaluation of effective factors in the success of resuscitation of patients with in-hospital cardiopulmonary arrest

مطالعات نشان مي دهند كه عوامل متعددي بر نتيجه احياء قلبي- ريوي موثر هستند، در اين مطالعه برآنيم تا فراواني عوامل مختلف و اثربخشي آنها را بر نتيجه احياء قلبي- ريوي مشخص نماييم. روش بررسي مطالعه به شيوه مقطعي و غيراحتمالي ساده از مراجعين (848 بيمار مورد احياء) به اورژانس بيمارستان الزهرا اصفهان بين فروردين 1394 تا فروردين 1398 كه در اورژانس بيمارستان دچار ايست قلبي-ريوي شده اند، انجام شد. براي تحليل با استفاده از شاخص هاي آماري و روش جداول متقاطع داده ها با Chi-squre test و Student’s t-test به تحليل داده ها پرداخته شده است و ميزان اثرات متغيرها بر نتيجه احياء براساس ماهيت متغيرها با استفاده از روش هاي Logistic regression مورد بررسي قرار گرفت. يافته ها در اين مطالعه از 848 بيمار مورد احياء قرار گرفته، 583 نفر (68/8%) مرد و 265 نفر (31/2%) زن بودند. ميانگين سني تمام بيماران مورد مطالعه 21/17±62/74 سال مي باشد. در احياء هاي موفق ميانگين سني بيماران 21/17±62/74 سال، حداكثر سن 116 سال و حداقل سن شش سال و در احياءهاي ناموفق ميانگين سني بيماران 21/79±62/33 سال، حداكثر سن 108سال و حداقل سن يك ماه بوده است. در اين مطالعه مشاهده شد كه با افزايش سن بيماران ميزان عدم موفقيت احياء افزايش مي يابد. وجود بيماري زمينه اي باعث افزايش عدم موفقيت در نتيجه احياء خواهد شد. نتيجه گيري نتايج نشان مي دهد كه عوامل متعددي در موفقيت احياء موثر مي باشد كه درجه اثرگذاري آنها بسته به موقعيت و شرايط بيماران متفاوت مي باشد و بايد باهم در نظر گرفته شود.

Previous studies have shown that several factors affect the outcome of cardiopulmonary resuscitation. In this study, we have evaluated the factors associated with the outcome of resuscitation in in-hospital cardiopulmonary arrest patients (IHCA) 002E. Methods: This cross-sectional non-probability study was performed on patients with inhospital cardiopulmonary arrest between 2015 and 2020 in the emergency department (ED) of Al-Zahra Hospital, Isfahan, Iran. Data were then collected from medical records to describe patient characteristics, arrest profile, and survival details. Factors associated with the dependent variable were examined Logistic regression. Results: Among 848 in-hospital cardiopulmonary arrests, 18 patients (2.1%) survived and were discharged from the hospital. The mean age of patients was 62.74±21.17 years, 583 (68.8%) were male, and 265 (31.2%) were female. The mean age of patients with successful resuscitation and those with unsuccessful resuscitation was 62.33±21.79 (6 to 116 years) and 61.58±21.20 (1 month to 108 years) years, respectively. The rate of unsuccessful resuscitation increased with increasing age (P=0.04). Also, the rate of unsuccessful resuscitation increased if there was an underlying disease (P=0.01). In frequency analysis of resuscitation services, emergency medicine with 633 (57.3%) resuscitation is in the first place in the number of resuscitations, of which 22.9% of them have been successful (ROSC). In the anesthesia service, of 2 resuscitations performed, both were successful. In the general surgery service, 36.5% of 63 resuscitations were successful, and the success rate for the neurosurgery service was 32.4% of 102 resuscitations. Analyzing the duration of successful and unsuccessful resuscitation has great importance. In successful resuscitation, the average time was 18.98 minutes and in unsuccessful resuscitation was 39.20 minutes. Also, the maximum and minimum time for successful resuscitations was 63 and 1 minutes. The maximum and minimum time for unsuccessful resuscitations was recorded as 60 and 10 minutes. Conclusion: The results showed that several factors were influential in cardiopulmonary resuscitation. Increasing age and underlying disease reduced the success of cardiopulmonary resuscitation.