Analysis Of Factors Influencing The Prognosis Of Patients With Cardiac Arrest In Hospital And The Evaluation Value Of ACCI Score In Their Prognosis

Objective: To explore the factors influencing the prognosis of patients with IHCA(In-hospital cardiac arrest),and to find the value of Age-adjusted Charlson comorbidity index(ACCI)score in evaluating the prognosis of patients with in-hospital cardiac arrest.Methods: Collect 2016.12 to 2019.12 in the second hospital,hebei medical university meets the criteria for the IHCA in patients with clinical data,including name,gender,age,IHCA places(general wards,care unit,emergency treatment,other),presence of ECG monitoring,The reason of cardiac arrest,CA time(06-18/18-06),medical history,initial 5 min(balloon mask/endotracheal intubation)ventilation way,the first time rhythm of the heart type(defibrillation/defibrillation),cardiopulmonary resuscitation(CPR)length,total dose of adrenaline,presence of electrical shock in the process of recovery,etc.The ACCI score was calculated based on the patient case data at admission.The groups were divided according to whether they were ROSC or not(ROSC group/N-ROSC group),and whether they were alive within 72 hours(survival group/death group).SPSS25.0 software was used to describe and analyze the data,and finally the influential factors of ROSC and discharge survival as well as the evaluation value of ACCI score on the prognosis of IHCA patients were obtained?Results: 1.For patients with IHCA,there were statistical differences in the ACCI score,the location of cardiac arrest,the presence or absence of monitoring,the type of heart rhythm monitored for the first time,the duration of cardiopulmonary resuscitation,and the total dose of epinephrine and age between the ROSC group and the N-ROSC group(P < 0.05).ACCI score,the type of heart rhythm monitored for the first time,duration of cardiopulmonary resuscitation,total dose of epinephrine,presence or absence of defibrillation during resuscitation,and occurrence time of CA and age were statistically different between the survival group and the death group(P < 0.05);2.Logistic regression analysis showed that the duration of CPR(O R=0.663;95%CI(0.561~0.782);P=0.000)and Defibrillation(OR=12.728;95%CI(1.102~146.950);P=0.0042)were the independent factors affecting R OSC in IHCA patients;ACCI score(OR=0.603;95%CI(0.441~0.824);P=0.002)and Duration of CPR(OR=0.811;95%CI(0.744~0.885);P=0.000) were the independent factors affecting the survival of IHCA patients within 72 hours after ROSC.3.The area under the ROC curve of the mortality of IHCA patients at 72 hours after ROSC was 0.722(95%CI(0.61~0.835),P = 0.001),the cut-off was 4 points,the sensitivity was 79.5%,and the specificity was 55.3%.Conclusions: 1.Defibrillation rhythm and the duration of CPR are independent fa ctors affecting ROSC in IHCA patients,while ACCI score and Duration of CPR are independent factors affecting the 72-hour survival of IHCA patients.2.The ACCI score can be used to assess the mortality of IHCA patients 72 hours after ROSC.