METHODS: We conducted a post-hoc analysis of a multicenter prospective study conducted between 2019 and 2021. Adult patients with OHCA treated with ECPR were included. The primary outcome was a favorable neurological outcome (Cerebral Performance Category of 1 or 2) at 30 days. An ELSO criteria score was assigned based on four criteria: (i) age < 70 years; (ii) witness; (iii) bystander CPR; and (iv) low-flow time (<60 min). Subgroup analysis based on initial cardiac rhythm was performed.
RESULTS: Among 9,909 patients, 227 with OHCA were included. The proportion of favorable neurological outcomes according to the number of ELSO criteria met were: 0.0% (0/3), 0 points; 0.0% (0/23), 1 point; 3.0% (2/67), 2 points; 7.3% (6/82), 3 points; and 16.3% (7/43), 4 points. A similar tendency was observed in patients with an initial shockable rhythm. However, no such relationship was observed in those with an initial non-shockable rhythm.
CONCLUSIONS: Patients who adhered more closely to specific inclusion criteria of the ELSO guidelines demonstrated a tendency towards a higher rate of favorable neurological outcomes. However, the relationship was heterogeneous according to initial rhythm.
方法:我们对2019年至2021年进行的多中心前瞻性研究进行了事后分析。包括接受ECPR治疗的成年OHCA患者。主要结果是在30天时良好的神经系统结局(脑功能类别为1或2)。根据四个标准分配ELSO标准评分:(i)年龄<70岁;(ii)证人;(iii)旁观者CPR;和(iv)低流量时间(<60分钟)。根据初始心律进行亚组分析。
结果:在9,909名患者中,227与OHCA包括在内。根据符合ELSO标准的数量,神经系统预后良好的比例为:0.0%(0/3),0分;0.0%(0/23),1分;3.0%(2/67),2分;7.3%(6/82),3分;和16.3%(7/43),4分。在具有初始可电击节律的患者中观察到类似的趋势。然而,在具有初始不可电击节律的患者中未观察到这种关系.
结论:更密切地坚持ELSO指南的特定纳入标准的患者表现出更高的神经系统转归率倾向。然而,根据初始节奏,这种关系是异质的。