| 李芸芸,潘慧斌,章杰,嵇朝晖,包芸.急诊急救相关要素对院外心脏骤停患者急诊自主循环恢复影响因素分析及预测模型构建[J].浙江中西医结合杂志,2026,36(2): |
| 急诊急救相关要素对院外心脏骤停患者急诊自主循环恢复影响因素分析及预测模型构建 |
| Analysis of influencing factors of emergency first aid related factors on emergency spontaneous circulation recovery in patients with out-of-hospital cardiac arrest and the construction of a prediction model |
| 投稿时间：2024-10-10 修订日期：2025-06-24 |
| DOI： |
| 中文关键词: 院外心脏骤停 自主循环恢复 影响因素 救治质量 |
| 英文关键词:out-of-hospital cardiac arrest recovery of spontaneous circulation influencing factors Quality of care |
| 基金项目:浙江省医药卫生科技计划项目（2020PY071）;湖州市公益性应用项目（2024GZB03）；本研究获得2019年度浙江省医院品管大赛进阶组铜奖； |
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| 中文摘要: |
| 摘要：目的：探讨急诊急救相关要素对院外心脏骤停（OHCA）患者急诊室内急救复苏结局的影响，明确OHCA患者在急诊室内获得自主循环恢复（ROSC）的独立相关因素，并构建预测模型。方法：选取2020年1月-2023年8月期间所收治的符合纳排标准的250例OHCA患者患者作为研究对象，依据急诊室抢救结果分为自主循环恢复（ROSC）组与死亡组，采集并对比两组患者的基本信息、院前急救医疗救治信息、院内救治信息，对所纳入影响因素分析采用Logistic回归分析，构建预测模型并绘制ROC曲线，评价预测模型家中。结果：两组患者对比发现OHCA事件发生地点与医院距离、是否接受旁观者复苏、是否院前预警、院前急救按压分数（CCF）、院内初始电节律、首次呼气末二氧化碳分压（EtCO2）等指标组间差异具有统计学意义（P值均＜0.05）；对差异指标纳入Logistic回归分析发现OHCA事件发生地点与医院距离、是否院前预警、院前急救CCF、院内初始电节律均是急诊室内心肺复苏救治质量对院外心脏骤停患者恢复自主循环的独立相关因素，基于上述独立相关因素构建联合预测模型，绘制联合预测模型的ROC曲线，获得ROC曲线下面积为0.978，P值＜0.05，说明联合预测模型有效，具有应用价值。结论：急诊急救相关因素是OHCA患者恢复自主循环的独立相关因素，基于急诊急救相关因素构建的联合预测模型能预测OHCA患者急诊室内复苏结局，具有一定的应用价值，值得进一步研究。 |
| 英文摘要: |
| Abstract: Objective: To explore the impact of emergency rescue-related factors on the outcomes of resuscitation in the emergency room for patients with out-of-hospital cardiac arrest (OHCA). Identify the independent associated factors for OHCA patients achieving return of spontaneous circulation (ROSC) in the emergency room and construct a predictive model.Methods: A total of 250 OHCA patients admitted between January 2020 and August 2023, meeting the inclusion criteria, were selected as study subjects. Based on emergency room resuscitation outcomes, they were divided into the ROSC group and the death group. Basic information, pre-hospital emergency medical care information, and in-hospital treatment information of the two groups were collected and compared. Logistic regression analysis was used for analyzing the influencing factors, constructing the predictive model, and plotting the ROC curve to evaluate the model.Results: Comparison between the two groups showed statistically significant differences in factors such as the location of the OHCA event and the distance to the hospital, whether bystander resuscitation was received, pre-hospital alerts, pre-hospital emergency compression fraction (CCF), initial in-hospital electrical rhythm, and first end-tidal carbon dioxide pressure (EtCO2) (all P values < 0.05). Logistic regression analysis of these differing indicators found that the location of the OHCA event and the distance to the hospital, pre-hospital alerts, pre-hospital emergency CCF, and initial in-hospital electrical rhythm were independent factors related to the quality of cardiopulmonary resuscitation (CPR) in the emergency room for OHCA patients to regain ROSC. A combined predictive model was constructed based on these independent factors, and the ROC curve for the model was plotted, yielding an area under the ROC curve of 0.978 with a P value < 0.05, indicating that the combined predictive model is effective and valuable for application.Conclusion: Emergency rescue-related factors are independent factors for ROSC in OHCA patients. A combined predictive model constructed based on these factors can predict the resuscitation outcomes of OHCA patients in the emergency room, having certain application value and warranting further research. |
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