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Long-term prognosis and clinical course of choking-induced cardiac arrest in patients without the return of spontaneous circulation at hospital arrival: a population-based community study from the Shizuoka Kokuho Database
BMC Emergency Medicine ( IF 2.3 ) Pub Date : 2022-07-06 , DOI: 10.1186/s12873-022-00676-8
Takahiro Miyoshi 1, 2 , Hideki Endo 2 , Hiroyuki Yamamoto 1, 2 , Koki Shimada 2 , Hiraku Kumamaru 1, 3 , Nao Ichihara 1, 3 , Yoshiki Miyachi 1 , Hiroaki Miyata 1, 2, 3
Affiliation  

The risk of choking increases with aging, and the number of cases of choking-induced cardiac arrest is increasing. However, few studies have examined the prognosis of choking-induced cardiac arrest. The aim of this study was to reveal the rates of survival and dependence on devices in the long term after choking-induced cardiac arrest. We analyzed data from the Shizuoka Kokuho Database, which consists of claims data of approximately 2.2 million people, from April 2012 to September 2018. We selected patients with choking-induced cardiac arrest who received cardiopulmonary resuscitation in the hospital. Patients were excluded if they were less than 20 years old, had an upper airway tumor, received ventilation assistance, or received enteral nutrition in the month prior to cardiac arrest. The primary outcome was death, and the secondary outcomes were the rates of survival at 3-months and independence on devices. Descriptive statistics are presented and compared among age groups (20–64 years, 65–74 years, 75–84 years, 85 years and older), and survival time analysis (Kaplan-Meier method) was performed. In total, 268 patients were analyzed, including 26 patients in the 20–64 age group, 33 patients in the 65–74 age group, 70 patients in the 75–84 age group, and 139 patients in the ≥85 age group. The overall 3-month survival rate was 5.6% (15/268). The 3-month survival rates were 3.8% (1/26) in the 20–64 age group, 15.2% (5/33) in the 65–74 age group, 8.6% (6/70) in the 75–84 age group, and 2.2% (3/139) in the ≥85 age group. The overall 12-month survival rate was 2.6% (7/268). Of the 7 patients who survived for 12 months, 3 received ventilation management and 5 received tube or intravenous feedings at 3 months. These survivors were still receiving ventilation assistance and tube feedings in the hospital and had not been discharged at 12 months. The prognosis of choking-induced cardiac arrest was extremely poor when patients were not resuscitated before hospital arrival. Those who survived were mostly dependent on assistive devices. Additionally, none of the survivors dependent on assistive devices had discontinued the use of the devices at the long-term follow-up.

中文翻译:

入院时未恢复自主循环的患者因窒息引起的心脏骤停的长期预后和临床过程:来自静冈国保数据库的基于人群的社区研究

窒息的风险随着年龄的增长而增加,窒息引起的心脏骤停的病例数量也在增加。然而,很少有研究检查窒息性心脏骤停的预后。本研究的目的是揭示窒息引起的心脏骤停后的长期存活率和对设备的依赖。我们分析了静冈国保数据库中的数据,该数据库包含 2012 年 4 月至 2018 年 9 月的约 220 万人的索赔数据。我们选择了在医院接受心肺复苏术的窒息性心脏骤停患者。如果患者年龄小于 20 岁、患有上气道肿瘤、接受通气辅助或在心脏骤停前一个月接受肠内营养,则被排除在外。主要结局是死亡,次要结果是 3 个月的生存率和对设备的独立性。描述性统计数据在年龄组(20-64 岁、65-74 岁、75-84 岁、85 岁及以上)之间进行了介绍和比较,并进行了生存时间分析(Kaplan-Meier 方法)。总共分析了 268 名患者,其中 20-64 岁年龄组 26 名患者、65-74 岁年龄组 33 名患者、75-84 岁年龄组 70 名患者和 85 岁以上年龄组 139 名患者。总体 3 个月生存率为 5.6% (15/268)。20-64 岁组的 3 个月生存率为 3.8% (1/26),65-74 岁组为 15.2% (5/33),75-84 岁组为 8.6% (6/70)组,2.2% (3/139) 在 85 岁以上的年龄组。总体 12 个月生存率为 2.6% (7/268)。在存活 12 个月的 7 名患者中,3 个月时接受通气管理,5 例接受管饲或静脉喂养。这些幸存者仍在医院接受通气辅助和管饲,并且在 12 个月时尚未出院。当患者在到达医院前未进行复苏时,窒息性心脏骤停的预后极差。幸存者大多依赖辅助设备。此外,在长期随访中,没有任何依赖辅助设备的幸存者停止使用这些设备。当患者在到达医院前未进行复苏时,窒息性心脏骤停的预后极差。幸存者大多依赖辅助设备。此外,在长期随访中,没有任何依赖辅助设备的幸存者停止使用这些设备。当患者在到达医院前未进行复苏时,窒息性心脏骤停的预后极差。幸存者大多依赖辅助设备。此外,在长期随访中,没有任何依赖辅助设备的幸存者停止使用这些设备。
更新日期:2022-07-06
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