본문 바로가기
KERD
논문KCI 등재

병원 밖 심정지 후 자발순환이 회복된 환자에서의 예후인자: 후향적인 코호트 연구

Men Associated with Good Prognosis after Return of Spontaneous Circulation after Out-of Hospital Cardiac Arrest: a Retrospective Study in One Emergency Center

1

조회

0

다운로드

3

인용

0

참고문헌

키워드

초록

Background: The aim of this study was to analyze the gender factors associated with good or bad prognosis after return of spontaneous circulation after out-of hospital cardiac arrest. Methods: The patients admitted to the intensive care unit after successful resuscitation after out-of hospital cardiac arrest were retrospectively identified and evaluated. Thirty days mortality after admission, and neurologic outcome at 6 months after hospital discharge (cerebral performance category [CPC]) were evaluated. Results: One hundred forty-two patients were evaluated in this study; there were 101 males (71.1%). The median age was 52 years old (43-63). Thirty days after admission, 85 patients (59.9%) survived, 40 patients had a good neurologic outcome (CPC 1-2). The factors associated 30 days mortality were cause of arrest (non-cardiac, p = 0.03), lactate in emergency department (p = 0.05) and the factors associated with good neurologic outcome were males (p = 0.007), young age (p = 0.01), body weight and height (p = 0.001), cause of death (cardiac, p = 0.000). Alcohols and smoking were not associated with mortality and neurologic outcome. In multiple logistic regression analysis, men had a 8-fold increased good neurologic outcome (CPC 1-2) (odds ratio [OR] 8.038, 95% Confidence Interval [CI] 1.079-59.903). Other factors associated with good neurologic outcome were cardiac cause of death (OR 5.523, 95% CI 1.562-19.533) and young age (OR 1.055, 95% CI 1.009-1.103). Conclusions: Men had a good neurologic outcome after return of spontaneous circulation after out-of hospital cardiac arrest in one emergency center. Other additional factors including gonadal hormones should be evaluated.

Abstract

Background: The aim of this study was to analyze the gender factors associated with good or bad prognosis after return of spontaneous circulation after out-of hospital cardiac arrest. Methods: The patients admitted to the intensive care unit after successful resuscitation after out-of hospital cardiac arrest were retrospectively identified and evaluated. Thirty days mortality after admission, and neurologic outcome at 6 months after hospital discharge (cerebral performance category [CPC]) were evaluated. Results: One hundred forty-two patients were evaluated in this study; there were 101 males (71.1%). The median age was 52 years old (43-63). Thirty days after admission, 85 patients (59.9%) survived, 40 patients had a good neurologic outcome (CPC 1-2). The factors associated 30 days mortality were cause of arrest (non-cardiac, p = 0.03), lactate in emergency department (p = 0.05) and the factors associated with good neurologic outcome were males (p = 0.007), young age (p = 0.01), body weight and height (p = 0.001), cause of death (cardiac, p = 0.000). Alcohols and smoking were not associated with mortality and neurologic outcome. In multiple logistic regression analysis, men had a 8-fold increased good neurologic outcome (CPC 1-2) (odds ratio [OR] 8.038, 95% Confidence Interval [CI] 1.079-59.903). Other factors associated with good neurologic outcome were cardiac cause of death (OR 5.523, 95% CI 1.562-19.533) and young age (OR 1.055, 95% CI 1.009-1.103). Conclusions: Men had a good neurologic outcome after return of spontaneous circulation after out-of hospital cardiac arrest in one emergency center. Other additional factors including gonadal hormones should be evaluated.

참고문헌 (20)

  1. Ahn KO, "Epidemiology and outcomes from non-traumatic out-of- hospital cardiac arrest in Korea: A nationwide observational study", Resuscitation, 81, pp.974~981 (2010)
  2. Kannel WB, "Sudden death: lessons from subsets in population studies", J Am Coll Cardiol, 5(6 Suppl), pp.141B~149B (1985)
  3. Perers E, "There is a difference in characteristics and outcome between women and men who suffer out of hospital cardiac arrest", Resuscitation, 40, pp.133~140 (1999)
  4. Weston CF, "Predicting survival from out-of-hospital cardiac arrest: a multivariate analysis", Resuscitation, 34, pp.27~34 (1997)
  5. Hallstrom AP, "Predictors of hospital mortality after out-of-hospital cardiopulmonary resuscitation", Crit Care Med, 13, pp.927~929 (1985)
  6. Kim C, "Out-of- hospital cardiac arrest in men and women", Circulation, 104, pp.2699~2703 (2001)
  7. Tunstall-Pedoe H, "Sex differences in myocardial infarction and coronary deaths in the Scottish MONICA population of Glasgow 1985 to 1991. Presentation, diagnosis, treatment, and 28-day case fatality of 3991 events in men and 1551 events in women", Circulation, 93, pp.1981~1992 (1996)
  8. Eachempati SR, "Gender-based differences in outcome in patients with sepsis", Arch Surg, 134, pp.1342~1347 (1999)
  9. Combes A, "Gender impact on the outcomes of critically ill patients with nosocomial infections", Crit Care Med, 37, pp.2506~2511 (2009)
  10. Nachtigall I, "Gender-related outcome difference is related to course of sepsis on mixed ICUs: a prospective, observational clinical study", Crit Care, 15, pp.R151~ (2011)
  11. Le Gall JR, "A new Simplified Acute Physiology Score (SAPS II) based on a European", North American multicenter study, 1993, pp.270, 2957~2963
  12. Adrie C, "OutcomeRea Study Group: Influence of gender on the outcome of severe sepsis: a reappraisal", Chest, 132, pp.1786~1793 (2007)
  13. Hubacek JA, "Gene variants of the bactericidal", permeability increasing protein and lipopolysaccharide binding protein in sepsis patients: gender-specific genetic predisposition to sepsis, 2001, pp.29, 557~561
  14. Federman DD, "The biology of human sex differences", N Engl J Med, 354, pp.1507~1514 (2006)
  15. Valentin A, "Gender-related differences in intensive care: a multiple-center cohort study of therapeutic interventions and outcome in critically ill patients", Crit Care Med, 31, pp.1901~1907 (2003)
  16. Wigginton JG, "Sex-related differences in the presentation and outcome of out-of-hospital cardiopulmonary arrest: a multiyear, prospective, population-based study", Crit Care Med, 30(4 Suppl), pp.S131~S136 (2002)
  17. Topjian AA, "American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators: Women of child-bearing age have better inhospital cardiac arrest survival outcomes than do equal-aged men", Crit Care Med, 38, pp.1254~1260 (2010)
  18. Alkayed NJ, "Neuroprotective effects of female gonadal steroids in reproductively senescent female rats", Stroke, 31, pp.161~168 (2000)
  19. Jover T, "Estrogen protects against global ischemia-induced neuronal death and prevents activation of apoptotic signaling cascades in the hippocampal CA1", J Neurosci, 22, pp.2115~2124 (2002)
  20. Ishrat T, "Effects of progesterone administration on infarct volume and functional deficits following permanent focal cerebral ischemia in rats", Brain Res, 1257, pp.94~101 (2009)

관련 논문AI추천

이 간행물의 다른 논문 (11건)