| Objective:To study the factors influencing the recovery of nervous system function in patients with cardiac arrest in hospital within 1 year.Methods:To collect the general information of the patients who had cardiac arrest in the hospital from October 1st,2019 to December 31 st,2020,and had regained the spontaneous circulation,the information of the condition of admission and the period of hospitalization,the information of the outcome and the data of the relevant time,the main outcome measure was a modified Rankin scale(Mrs)score to assess the neurological recovery of patients with in-hospital Cardiac arrest and Rosc within 1year.Finally,the characteristics of the patients with poor neurological recovery were analyzed by statistical methods,and the factors influencing the outcome of the patients within 1 year were summarized.Results:(1)A total of 173 patients were included in this study,of which 128(74.0%)were males and 45(26.0%)were females.More than half of the patients were admitted for cardiogenic reasons(93(53.8%)),the main causes of non-cardiogenic patients were neurogenic(28 cases,16.2%),basic diseases(44 cases,25.4%)and emergency room(75 cases,43.4%)157 cases(90.8%)had ECG monitoring,66 cases(38.2%)had ventricular fibrillation,88 cases(50.9%)had CPR,46 cases(26.6%)had one defibrillation and 40 cases(23.1%)had ≥2 defibrillation The most common mode of ventilation was invasive ventilator assisted ventilation(79 cases,45.7%),no epinephrine(72 cases,41.6%),antiarrhythmic agent(42 cases,24.3%),pressor(81cases,46.8%)The majority of patients(93.6%)were treated immediately from CA to first defibrillation or CPR,78 patients(45.1%)were resuscitated to first ROSC for less than 10 minutes,and 78 patients(45.1%)had mRS score of 5(45.1%)99 cases(57.2%)died in hospital,33 cases(44.6%)had a mRS score of 0 in one month,42cases(62.7%)had a mRS score of 0 in six months,and 42 cases(62.7%)had a mRS score of 0 in one year Mrs Scores of 20-minute ROSC showed good prognosis in 24cases(13.9%),58 cases(78.4%)in one month mRS scores,and 57 cases(85.1%)in six months mRS scores One-year Mrs Score showed that 56 patients(88.9%)had good prognosis,the mean age was(61.69 ± 14.20)years,and the quartile of hospital stay was [7.00(1.00,11.00)] days.(2)Univariate analysis showed that there were significant differences in gender,age,reason of admission,number of underlying diseases,location of CA,cardiac rhythm during CA,whether defibrillation,number of defibrillation,mode of ventilation,dosage of Epinephrine,whether to use pressor drug,whether to defibrillation immediately after CA,and time between resuscitation and first ROSC.There were significant differences in age,reason of admission,number of underlying diseases,cardiac rhythm at CA,mode of ventilation,dosage of epinephrine and time between resuscitation and first ROSC.There were significant differences in age,reason for admission,number of underlying diseases,location of IHCA,mode of ventilation,time from resuscitation to first ROSC and length of stay between patients with IHCA and those with poor recovery.There were significant differences in age,reason of admission,number of underlying diseases,mode of ventilation,whether to defibrillation immediately and time between resuscitation and first ROSC.(3)The results of multiple Logistic regression analysis showed that the patients with IHCA had good recovery and poor recovery at 20 min.The number of underlying diseases and the amount of epinephrine were the risk factors of poor recovery of nerve function.The number of underlying diseases and hospitalization for non-cardiogenic reasons were the risk factors for poor nerve function recovery.The number of basic diseases and the length of stay were the risk factors for the poor recovery of nerve function.One-year survival and discharge from IHCA: Ventilation and time from CA to first defibrillation or CPR were risk factors for poor neurological recovery.Conclusions:(1)At ROSC 20 minutes,the patients with IHCA had less underlying disease and less epinephrine accumulation during resuscitation,which was beneficial to the recovery of neurological function.(2)The patients with IHCA survived for 1 month and were less likely to have underlying diseases and cardiogenic causes of admission.(3)The patients with IHCA survived for 6 months,less basic diseases and shorter hospitalization days were beneficial to the recovery of nervous system function.(4)Without endotracheal intubation and shortening the time from CA to first defibrillation or CPR were beneficial to the recovery of nervous system function in patients with IHCAAFTER 1 year. |
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