AIMS:to report the incidence, characteristics, and outcome of in-hospital cardiac arrest (IHCA) in a large Italian region. SETTING:all hospitals participating in the IHCA Registry Initiative of Piedmont. METHODS:observational cohort study in adult (>18year old) inpatients resuscitated from IHCA during three consecutive years (2012-2014). The main outcome measures were IHCA incidence and survival to hospital discharge. RESULTS:A total of1539 arrests in adult inpatients were recorded in the study period, yielding an overall incidence of 1.51 arrests/1000 admissions. The incidence was highest at day 1 after hospital admission and in the morning hours, with a peak at 9.00 a.m. Median age was 77 (interquartile range 68-83) years. The presenting rhythm was ventricular fibrillation/pulseless ventricular tachycardia in 291/1539 (18.9%) cases. A total of 549/1539 (35.7%) patients achieved recovery of spontaneous circulation (ROSC) and 228/1539(14.8%) survived hospital discharge, with 207 (90.8%) of the latter having good neurological outcome (Cerebral Performance Categories [CPC] 1 or 2).After adjustment for major confounders, a pre-arrest CPC=1, a cardiac cause of arrest, a shockable presenting rhythm, and a shorter duration of resuscitation were independently associated with a higher likelihood of survival to discharge. CONCLUSIONS:in this Italian registry the incidence of IHCA and its circadian distribution were comparable to those in the NCAA registry in the UK. Patients were older and had a lower ROSC rate than these observed in other large IHCA registries, but post-ROSC survival rate and factors affecting survival to discharge were similar.

译文

目的:报告意大利大面积医院内心脏骤停(IHCA)的发生率,特征和结局。
地点:所有参加皮埃蒙特IHCA注册计划的医院。
方法:连续三年(2012-2014年)从IHCA复苏的成人(> 18岁)住院患者的观察性队列研究。主要结果指标是IHCA发生率和出院生存率。
结果:在研究期间,共记录了1539名成人住院病人的逮捕,总的发生率为1.51名逮捕/ 1000例入院。发病率最高的是入院后的第一天和早晨,最高时间是上午9.00点,中位年龄为77岁(四分位间距为68-83岁)。出现的节律为室颤/无脉性室性心动过速,发生在291/1539例中(占18.9%)。共有549/1539(35.7%)的患者实现了自发性循环(ROSC)的恢复,并且有228/1539(14.8%)的患者在出院后存活,其中207(90.8%)的患者具有良好的神经系统预后(脑功能分类[CPC] [1]或[2])。在对主要混杂因素进行调整之后,逮捕前的CPC = 1,心脏骤停的原因,令人震惊的呈现节律和较短的复苏持续时间与更高的存活存活率独立相关。
结论:在该意大利注册中心中,IHCA的发生率及其昼夜节律分布与英国的NCAA注册中心相当。与其他大型IHCA登记处观察到的患者相比,患者年龄更大且ROSC率较低,但是ROSC后的存活率和影响出院存活率的因素相似。

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