院外心脏骤停不实施复苏相关因素的研究

Study on the factors related to not attempting resuscitation for out-of-hospital cardiac arrest

目的探讨院外心脏骤停(out-of-hospital cardiac arrest,OHCA)患者未实施心肺复苏(cardiopulmonary resuscitation,CPR)的流行病学因素,以分析未复苏的原因和临床指征。方法收集北京急救中心2020年1月至12月符合入组标准的未实施心肺复苏的OHCA患者,按照Utstein模式设计登记注册表,采用卡方检验回顾性分析患者流行病学资料。结果本研究共收集5977例患者,按照年龄分为两组,其中年龄≤80岁2349例,年龄≥81岁3628例,与低年龄组比,年龄较大组因疾病(97.0%)和家属放弃(99.4%)而未实施CPR的占比更高,差异具有统计学意义(均P<0.01)。结论有基础病80岁以上高龄老人在家发生OHCA概率大,现场目击者多为家属且不能够及时实施CPR,急救人员到现场后发现患者心脏骤停时间过长、已经明显死亡,家属或监护人会选择放弃救治。

Objective To explore the epidemiological factors of patients with OHCA who did not attempt CPR,and analyze the reasons and clinical features of non resuscitation.Methods Data from OHCA patients who did not undergo CPR were collected from January 2020 to December 2020 at Beijing Emergency Medical Center.The registration form was designed according to the Utstein model,and the data were analyzed retrospectively by the chi-square test.Results A total of 5977 patients were enrolled and divided into two groups according to age:2349 patients aged≤80 years old and 3628 patients aged≥81 years old.Compared with the younger group,the proportion of patients in the older group who did not undergo CPR due to disease(97.0%)and family desertion(99.4%)were higher,and the difference was statistically significant(both P<0.01).Conclusions Elderly people over 80 years old with underlying diseases have a high probability of developing OHCA at home.Most of the witnesses at the scene were family members and could not implement CPR in time.After the emergency personnel arrived at the scene,they found that the patient had been in cardiac arrest for too long and had apparently died.Family members would choose to give up treatment.