Prognostic indicators and outcome prediction model for patients with return of spontaneous circulation from cardiopulmonary arrest: The Utstein Osaka Project

被引：51

作者：

Hayakawa, Koichi ^{[1
]}

Tasaki, Osamu ^{[2
]}

Hamasaki, Toshimitsu ^{[3
]}

Sakai, Tomohiko ^{[2
]}

Shiozaki, Tadahiko ^{[2
]}

Nakagawa, Yuko ^{[2
]}

Ogura, Hiroshi ^{[2
]}

Kuwagata, Yasuyuki ^{[2
]}

Kajino, Kentaro ^{[4
]}

Iwami, Taku ^{[5
]}

Nishiuchi, Tatsuya ^{[6
]}

Hayashi, Yasuyuki ^{[7
]}

Hiraide, Atsushi ^{[8
]}

Sugimoto, Hisashi ^{[9
]}

Shimazu, Takeshi ^{[2
]}

机构：

[1] Osaka Neurol Inst, Toyonaka, Osaka 5610836, Japan

[2] Osaka Univ, Grad Sch Med, Dept Traumatol & Acute Crit Med, Suita, Osaka 5650871, Japan

[3] Osaka Univ, Grad Sch Med, Dept Biomed Stat, Suita, Osaka 5650871, Japan

[4] Osaka Police Hosp, Emergency & Crit Care Med Ctr, Osaka 5430035, Japan

[5] Kyoto Univ, Hlth Serv, Sakyo Ku, Kyoto 6068501, Japan

[6] Osaka City Univ, Grad Sch Med, Dept Crit Care & Emergency Med, Osaka 5450051, Japan

[7] Saiseikai Senri Hosp, Senri Crit Care Med Ctr, Suita, Osaka 5650862, Japan

[8] Kinki Univ Hosp, Osaka 5898511, Japan

[9] Hoshigaoka Koseinenkin Hosp, Hirakata, Osaka 5738511, Japan

来源：

RESUSCITATION | 2011年 / 82卷 / 07期

关键词：

Cardiac arrest; Emergency medical service; Out-of-hospital CPR; Pulseless electrical activity; Return of spontaneous circulation; Utstein template; Ventricular fibrillation; Witnessed cardiac arrest; HOSPITAL CARDIAC-ARREST; NEURON-SPECIFIC ENOLASE; VENTRICULAR-FIBRILLATION; THERAPEUTIC HYPOTHERMIA; COMATOSE SURVIVORS; OHCA SCORE; RESUSCITATION; ASYSTOLE; PEA;

D O I：

10.1016/j.resuscitation.2011.02.045

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: To determine the most important indicators of prognosis in patients with return of spontaneous circulation (ROSC) following out-of-hospital cardiopulmonary arrest (OHCA) and to develop a best outcome prediction model. Design and patients: All patients were prospectively recorded based on the Utstein Style in Osaka over a period of 3 years (2005-2007). Criteria for inclusion were a witnessed cardiac arrest, age greater than 17 years, presumed cardiac origin of the arrest, and successful ROSC. Multivariate logistic regression (MLR) analysis was used to develop the best prediction model. The dependent variables were favourable outcome (cerebral-performance category [CPC]: 1-2) and poor outcome (CPC: 3-5) at 1 month after the event. Eight explanatory pre-hospital variables were used concerning patient characteristics and resuscitation. External validation was performed on an independent set of Utstein data in 2007. Results: Subjects comprised 285 patients in VF and 577 patients with pulseless electrical activity (PEA)/asystole. The percentage of favourable outcomes was 31.9% (91/285) in VF and 5.7% (33/577) in PEA/asystole. The most important prognostic indicators of favourable outcome found by MLR were age (p = 0.10), time from collapse to ROSC (TROSC) (p < 0.01), and presence of pre-hospital ROSC (PROSC) (p = 0.15) for VF and age (p = 0.03), TROSC (p < 0.01), PROSC (p < 0.01), and conversion to VF (p = 0.01) for PEA/asystole. For external validation data, areas under the receiver-operating characteristic curve were 0.867 for VF and 0.873 for PEA/asystole. Conclusions: A model based on four selected indicators showed a high predictive value for favourable outcome in OHCA patients with ROSC. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

引用

页码：874 / 880

页数：7

共 28 条

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