摘要
目的探讨心搏骤停(CA)患者缺氧性肝炎(HH)与院内死亡风险的关系。方法提取DRYAD(datadryad.org)数据库CA后急性肝功能紊乱的374例附带数据,根据是否发生HH将患者分为HH组和非HH组,比较两组患者基线资料,采用logistic回归模型分析HH与院内死亡风险的相关性。结果374例患者中非HH组347例,HH组27例。HH组比非HH组死亡风险高,差异有统计学意义(P<0.01)。单因素logistic回归分析,ICU住院时间延长、CA目击者、旁观者心肺复苏(CPR)是CA患者院内死亡的保护因素,而自主循环恢复(ROSC)时间延长、肾上腺素用量增加、非心脏疾病原因、不可电击心律、乳酸升高、HH是CA患者院内死亡升高的危险因素。logistic回归分析显示,HH组比非HH组死亡风险增加,logistic回归模型分析HH死亡OR=6.69,95%CI:1.92~22.62,P<0.01。调整模型,最终HH死亡OR=6.01,95%CI:1.68~21.48,P<0.01。结论CA患者合并HH死亡风险较非HH者死亡风险高。
Objective To investigate the relationship between hypoxic hepatitis and the risk of in-hospital death in patients with cardiac arrest.Methods The data of 374 cases of acute liver dysfunction after cardiac arrest were extracted from DRYAD database(datadryad.org).According to the diagnostic criteria of hypoxic hepatitis(HH)the patients were divided into HH group(n=27)and non-HH group(n=347).The baseline data were compared between HH and non-HH groups.The association between hypoxic hepatitis and the risk of in-hospital mortality was analyzed using logistic regression model.Results The HH group had a higher risk of in-hospital death than the non-HH group(P<0.01).The univariate logistic regression analysis showed that prolonged ICU stay,witness to cardiac arrest,and bystander cardiopulmonary resuscitation(CPR)were protective factors for in-hospital death,while prolonged time of returning autonomic circulation,increased epinephrine use,non-cardiac causes,non-electric shockable rhythm,elevated lactate,and hypoxic hepatitis were independent risk factors for elevated in-hospital death in patients with cardiac arrest.The OR of HH for in-hospital death was 6.69(95%CI:1.92-22.62,P<0.01),after adjusting the model,the final OR of HH for in-hospital mortality was 6.01(95%CI:1.68-21.48,P<0.01).Conclusion Patients with cardiac arrest combined with hypoxic hepatitis have a higher risk of inhospital death.
作者
潘克跃
叶渊文
陈玲珑
PAN Keyue;YE Yuanwen;CHEN Linlong(Graduate School,Zhejiang Chinese Medical University,Hangzhou 310053,China;不详)
出处
《浙江医学》
CAS
2023年第2期168-172,共5页
Zhejiang Medical Journal
关键词
缺氧性肝炎
死亡风险
心搏骤停
心肺复苏
Hypoxic hepatitis
Risk of death
Cardiac arrest
Cardiopulmonary resuscitation
