Abstract:
Cardiopulmonary resuscitation (CPR) research traditionally focuses on survival. In 2018, the International Liaison Committee on Resuscitation (ILCOR) proposed more patient-centered outcomes. Our narrative review assessed clinical trials after 2018 to identify the trends of outcome metrics in the field OHCA research. We performed a search of the PubMed database from 1 January 2019 to 22 September 2023. Prospective clinical trials involving adult humans were eligible. Studies that did not report any patient-related outcomes or were not available in full-text or English language were excluded. The articles were assessed for demographic information and primary and secondary outcomes. We included 89 studies for analysis. For the primary outcome, 31 (35%) studies assessed neurocognitive functions, and 27 (30%) used survival. For secondary outcomes, neurocognitive function was present in 20 (22%) studies, and survival was present in 10 (11%) studies. Twenty-six (29%) studies used both survival and neurocognitive function. Since the publication of the COSCA guidelines in 2018, there has been an increased focus on neurologic outcomes. Although survival outcomes are used frequently, we observed a trend toward fewer studies with ROSC as a primary outcome. There were no quality-of-life assessments, suggesting a need for more studies with patient-centered outcomes that can inform the guidelines for cardiac-arrest management.
摘要:
心肺复苏(CPR)研究传统上侧重于生存。2018年,国际复苏联络委员会(ILCOR)提出了更多以患者为中心的结果。我们的叙述性综述评估了2018年后的临床试验,以确定OHCA研究领域结果指标的趋势。我们从2019年1月1日至2023年9月22日对PubMed数据库进行了搜索。涉及成年人的前瞻性临床试验是合格的。未报告任何患者相关结果或无法获得全文或英语的研究被排除。评估文章的人口统计信息以及主要和次要结果。我们纳入了89项研究进行分析。对于主要结果,31项(35%)研究评估了神经认知功能,和27(30%)使用生存。对于次要结果,神经认知功能出现在20项(22%)研究中,在10项(11%)研究中存在生存率。26项(29%)研究同时使用了生存和神经认知功能。自2018年COSCA指南发布以来,人们越来越关注神经系统结局。尽管生存结果经常被使用,我们观察到以ROSC为主要结局的研究减少的趋势.没有生活质量评估,提示需要进行更多的以患者为中心的研究,以指导心脏骤停治疗.