休克指数和修正休克指数评估心脏骤停自主循环恢复患者的预后

To assess the prognosis of patients with return of spontaneous circulation after cardiac arrest by shock index and adjusted shock index

目的 评价休克指数和体温修正休克指数（以下简称“修正休克指数”）评估心脏骤停后自主循环恢复患者预后的价值.方法 以心肺复苏Utstien模式前瞻性注册登记并分析111例院内心脏骤停经心肺复苏恢复自主循环患者的生命体征等资料,以进一步评价休克指数和修正休克指数评估其预后的价值.结果 收缩压、心率在成活出院组与死亡组患者组间差异无统计学意义,P＞0.05.死亡组患者休克指数和修正休克指数[（1.109±0.428）和（1.082 ±0.410）]明显高于成活出院组[（0.899±0.303）和（0.844 ±0.265）],P＜0.05.修正休克指数＞1.1的患者死亡风险比为5.4,明显高于收缩压＜90 mm Hg组（1.6）和心率＞100次/min组（3.1）,P＞0.05.休克指数＞1.1预测该组患者死亡风险的比值比为2.8.结论 休克指数和修正休克指数是易于记忆和获取的有效评价指标,有助于预测诸如心脏骤停循环恢复患者最终死亡或成活出院等病情预后.

Objective To examine the usefulness of shock index （Sl） and adjusted shock index （corrected to temperature） （ASI） in predicting prognosis of patients with return of spontaneous circulation after cardiac arrest.Methods A prospective study,which data such as vital signs of the cases were collected by the Utstein template,was conducted in 111 of cases with return of spontaneous circulation after cardiac arrest to assess the value of SI and ASI for predicting their prognoses.Results There was no evidence to show difference between the cases with survival to hospital discharge and the ones who died about systolic blood pressure and heart rate （P ＞0.05）.SI and ASI [（1.109 ±0.428） and （1.082 ±0.410）] of the group of death were higher significantly than the ones [（0.899 ± 0.303） and （0.844 ± 0.265）] of the group with survival to hospital discharge,P ＜ 0.05.The risk of death was elevated in the group with ＂ASI ＞ 1.1＂,which odds ratio （5.4） higher than the ones of ＂systolic blood prcssure ＜90 mm Hg＂ （1.6）and ＂ventricular rat ＞ 100 beat/min＂ （3.1） significantly.The odds ratio of death with ＂AS ＞ 1＂ was 2.8.Conclusions Shock index and adjusted shock index are easy to derive and conducive to predict effectively diseases prognosis such as survival to hospital discharge or death of patients with ROSC.