郑州地区成人院外心搏骤停患者CPR与性别的相关性研究——2016年至2019年病例分析

Study on correlation between cardiopulmonary resuscitation of adult patients with out-of-hospital cardiac arrest and gender in Zhengzhou district:analysis of patients from 2016 to 2019

目的探讨郑州地区成人院外心搏骤停(OHCA)患者心肺复苏(CPR)与性别之间的关系。方法采用回顾性研究方法,收集郑州地区2016年7月至2019年6月OHCA患者的人口统计学指标(包括性别、年龄)以及CPR指标〔包括心搏骤停(CA)原因、是否有旁人CPR、急救反应时间、初始心律、是否接受除颤、通气方式、是否使用肾上腺素、是否自主循环恢复(ROSC)〕的相关数据,对数据进行单因素和多因素Logistic回归分析以及年龄亚组分析。结果共纳入3429例OHCA患者,女性OHCA患者少于男性〔27.2%(931/3429)比72.8%(2498/3429)〕,其中ROSC患者45例(占1.3%)。单因素分析显示,OHCA患者年龄、初始心律和接受除颤比例存在性别差异,其中女性年龄明显大于男性(P<0.001),初始心律情况较男性更差(χ^(2)=7.974,P=0.019),接受除颤比例亦明显低于男性(χ^(2)=9.025,P=0.003),但ROSC情况并无性别差异(χ^(2)=0.070,P=0.792)。多因素Logistic回归分析显示,OHCA患者ROSC情况也无性别差异〔优势比(OR)=1.435,95%可信区间(95%CI)为0.729~2.825,P=0.296〕。年龄亚组分析显示,18~49岁亚组与≥50岁亚组OHCA患者的ROSC情况均无性别差异(18~49岁组:OR=1.738,95%CI为0.489~6.175,P=0.393;≥50岁组:OR=1.295,95%CI为0.565~2.965,P=0.541)。结论郑州地区男性较女性更容易发生OHCA,女性OHCA患者年龄大于男性,且初始心律情况较男性更差,但ROSC情况并无性别差异,不同性别OHCA患者在50岁前后的ROSC情况也无明显差异。

Objective To study the correlation between cardiopulmonary resuscitation(CPR)of adult patients with out-of-hospital cardiac arrest(OHCA)and gender in Zhengzhou district,Henan,China.Methods A retrospective study was conducted.The demographic indicators(gender,age)and CPR indicators[causes of cardiac arrest(CA),CPR bystander present or not,rescue response time,initial cardiac rhythm,defibrillation accepted or not,ventilation mode,use of epinephrine or not,return of spontaneous circulation(ROSC)or not]related data of adults with OHCA were collected from July 2016 to June 2019 in Zhengzhou district.Univariate and multivariate logistic regression analyses were used to analyze the data and age subgroups.Results This study enrolled 3429 patients in whom the number of female OHCA patients was less than that of male OHCA patients[27.2%(931/3429)vs.72.8%(2498/3429)],and there were 45 patients(1.3%)with ROSC.Univariate analysis showed that there were gender differences in proportions of OHCA patients'age,initial cardiac rhythm and accepting defibrillation;among the OHCA paients,the women were obviously older than men(P<0.001),women's cardiac initial rhythm was worse than that in men's(χ^(2)=7.974,P=0.019)and women's proportion of receiving defibrillation was significantly less(χ^(2)=9.025,P=0.003),but there was no gender difference in ROSC(χ^(2)=0.070,P=0.792).Multivariate logistic regression analysis also showed no gender difference in OHCA patients'ROSC situation[odds ratio(OR)=1.435,95%confidence interval(95%CI)was 0.729-2.825,P=0.296].The age subgroup analysis showed that in the comparisons of gender difference in rate of ROSC in OHCA patients in age 18-49 group and age≥50 group,there were no gender statistical significant differences(age 18-49:OR=1.738,95%CI was 0.489-6.175,P=0.393;age≥50:OR=1.295,95%CI was 0.565-2.965,P=0.541)in both age subgroups.Conclusion The occurrence of OHCA in man is more likely than that in women in Zhengzhou district,Henan,China.Women with OHCA are older than men with the same disease and the initial cardiac rhythm is worse in women than in man,but there is no significant gender difference in ROSC situation,which is approximately similar in the ages before and after 50 years old group.