Background

Prior studies have investigated the association between duration of resuscitation and short-term outcomes following in-hospital cardiac arrest (IHCA). However, it remains unknown whether there is an association between duration of resuscitation and long-term survival and functional outcomes.

Method

We linked data from the Danish in-hospital cardiac arrest registry with nationwide registries and identified 8,727 patients between 2013 and 2019. Patients were stratified into four groups (A-D) according to quartiles of duration of resuscitation. Standardized average probability of outcomes was estimated using logistic regression.

Results

Of 8,727 patients, 53.1% (n=4,604) achieved return of spontaneous circulation. Median age was 74 (1^st-3^rd quartile [Q1-Q3] 65-81 years) and 63.1% were men.

Among all IHCA patients the standardized 30-day survival was 62.0% (95% CI 59.8%-64.2%) for group A (< 5 minutes), 32.7% (30.8%-34.6%) for group B (5-11 minutes), 14.4% (12.9%-15.9%) for group C (12-20 minutes) and 8.1% (7.0%-9.1%) for group D (21 minutes or more). Similarly, 1-year survival was also highest for group A (50.4%; 48.2%-52.6%) gradually decreasing to 6.6% (5.6%-7.6%) in group D.

Among 30-day survivors, survival without anoxic brain damage or nursing home admission within one-year post-arrest was highest for group A (80.4%; 78.2%-82.6%), decreasing to 73.3% (70.0%-76.6%) in group B, 67.2% (61.7%-72.6%) in group C and 73.3% (66.9%-79.7%) in group D.

Conclusion

Shorter duration of resuscitation attempt during an IHCA is associated with higher 30-day and 1-year survival. Furthermore, we found that the majority of 30-day survivors were still alive 1-year post-arrest without anoxic brain damage or nursing home admission despite prolonged resuscitation.

中文翻译：

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院内心脏骤停后复苏的持续时间和长期结果：一项全国性的观察性研究

背景

先前的研究已经调查了复苏持续时间与院内心脏骤停 (IHCA) 后短期结果之间的关系。然而，目前尚不清楚复苏持续时间与长期生存和功能结果之间是否存在关联。

方法

我们将丹麦院内心脏骤停登记处的数据与全国登记处相关联，确定了 2013 年至 2019 年间的 8,727 名患者。根据复苏持续时间的四分位数将患者分为四组 (AD)。使用逻辑回归估计结果的标准化平均概率。

结果

在 8,727 名患者中，53.1% (n=4,604) 实现了自主循环的恢复。中位年龄为 74 岁（1 ^st -3 ^rd四分位数 [Q1-Q3] 65-81 岁），63.1% 为男性。

在所有 IHCA 患者中，A 组（<5 分钟）的标准化 30 天生存率为 62.0%（95% CI 59.8%-64.2%），B 组（5-11 分钟）为 32.7%（30.8%-34.6%） ，C组（12-20分钟）为14.4％（12.9％-15.9％），D组（21分钟或更长时间）为8.1％（7.0％-9.1％）。同样，A 组的 1 年生存率也最高（50.4%；48.2%-52.6%），D 组逐渐下降至 6.6%（5.6%-7.6%）。

在 30 天幸存者中，A 组在逮捕后 1 年内无缺氧性脑损伤或入住疗养院的存活率最高（80.4%；78.2%-82.6%），在 A 组降至 73.3%（70.0%-76.6%）。 B组，C组67.2%（61.7%-72.6%），D组73.3%（66.9%-79.7%）。

结论

IHCA 期间较短的复苏尝试时间与较高的 30 天和 1 年生存率相关。此外，我们发现大多数 30 天幸存者在逮捕后 1 年仍然活着，尽管进行了长时间的复苏，但没有缺氧性脑损伤或入住疗养院。