成人创伤后心脏骤停患者复苏结局影响因素研究

Study on the influencing factors of resuscitation outcomes for adult trauma patients with cardiac arrest

目的探讨成人创伤后院内心脏骤停患者复苏结局影响因素并进一步分析相关临床预测效能,旨在为早期准确识别死亡高危人群及制定更为积极有效干预方案提供指导。方法回顾性纳入2021年1月至2023年1月于本院治成人创伤后院内心脏骤停患者共87例,根据复苏结局分为死亡组(70例)和存活组(17例);比较死亡组和存活组临床特征资料,将上述组间比较有统计学意义指标纳入Logistics回归模型,采用多因素法评估成人创伤后院内心脏骤停患者复苏结局独立影响因素;描绘ROC曲线分析上述独立影响因素预测成人创伤后院内心脏骤停患者复苏结局的临床效能。结果本研究纳入成人创伤后院内心脏骤停患者共87例复苏后死亡70例,存活17例,死亡率为80.46%。单因素分析结果显示,年龄、是否为心源性病因及心肺复苏持续时间均与成人创伤后院内心脏骤停患者复苏结局有关(P<0.05);将单因素分析有统计学意义指标纳入Logistics回归模型,分析结果显示年龄、是否为心源性病因及心肺复苏持续时间均是成人创伤后院内心脏骤停患者复苏结局独立影响因素(P<0.05);ROC曲线分析结果显示,年龄、是否为心源性病因及心肺复苏持续时间均可用于成人创伤后院内心脏骤停患者复苏结局预测,且三种指标联合预测曲线下面积、灵敏度及特异度均显著优于上述单一指标预测(P<0.05)。结论成人创伤后院内心脏骤停患者复苏结局可能与年龄、是否为心源性病因及心肺复苏持续时间有关;而上述指标联合在预测复苏结局方面显示出更佳临床价值。

Objective To explore the influencing factors of resuscitation outcomes in adult patients with cardiac arrest after trauma and further analyze the relevant clinical predictive efficacy,aiming to provide guidance for early and accurate identification of high-risk mortality populations and the development of more proactive and effective intervention plans.Methods 87 adult trauma patients with hospital cardiac arrest treated in our hospital from January 2021 to January 2023 were retrospectively included.According to the resuscitation outcome,they were divided into the death group(70 cases)and the survival group(17 cases).The clinical characteristics of the death group and the survival group were compared,and the statistically significant indicators between the two groups were incorporated into the Logistics regression model.Multiple factor method was used to evaluate the independent influencing factors of resuscitation outcomes in adult patients with cardiac arrest after trauma.The clinical efficacy of ROC curve analysis was described in predicting the resuscitation outcomes of adult patients with cardiac arrest after trauma,based on the independent influencing factors.Results 87 adult trauma patients with hospital cardiac arrest were included in this study.Among them,70 died after resuscitation,17 survived,and the mortality rate was 80.46%.The results of univariate analysis showed that age,cardiogenic etiology,and duration of cardiopulmonary resuscitation were all related to the resuscitation outcomes of adult truama patients with cardiac arrest(P<0.05).Incorporating statistically significant indicators from univariate analysis into the Logistics regression model,the analysis results showed that age,cardiogenic etiology,and duration of cardiopulmonary resuscitation were independent factors affecting the resuscitation outcomes of adult trauma patients with cardiac arrest(P<0.05).The ROC curve analysis results showed that age,cardiogenic etiology,and duration of cardiopulmonary resuscitation can all be used to predict the resuscitation outcomes of adult trauma patients with cardiac arrest,and the combined prediction of the three indicators showed significantly better area,sensitivity,and specificity under the curve than the single indicator prediction(P<0.05).Conclusion The resuscitation outcome of adult trauma patients with cardiac arrest may be related to age,whether it is a cardiogenic cause,and the duration of cardiopulmonary resuscitation.The combination of the above indicators shows better clinical value in predicting recovery outcomes.