PDF(Pubmed)
Abstract：
Background: Though out-of-hospital CA (OHCA) is widely reported, data on in-hospital CA (IHCA) and especially cardiac arrest (CA) in the emergency department (CAED) are scarce. This study aimed to determine the frequency, prevalence, and clinical features of unexpected CAED and compare the data with those of expected CAED. Methods: We defined unexpected CAED as CA occurring in patients in non-critical ED-care areas; classified as not requiring strict monitoring. This classification was the modified Japanese Triage and Acuity Scale and physician assessment. A retrospective analysis of cases from 2016 to 2018 was performed, in comparison to other patients experiencing CAED. Results: The 38 cases of unexpected CA in this study constituted 34.5% of CA diagnosed in the ED and 8.4% of all CA treated in the ED. This population did not differ significantly from other CAED regarding demographics, comorbidities, and survival rates. The commonest symptoms were dyspnoea, disorders of consciousness, generalised weakness, and chest pain. The commonest causes of death were acute myocardial infarction, malignant neoplasms with metastases, septic shock, pulmonary embolism, and heart failure. Conclusions: Unexpected CAED represents a group of potentially avoidable CA and deaths. These patients should be analysed, and ED management should include measures aimed at reducing their incidence.
摘要：
背景：虽然院外CA（OHCA）被广泛报道，关于院内CA(IHCA),尤其是急诊科(CAED)心脏骤停(CA)的数据很少.这项研究旨在确定频率，患病率,和意外CAED的临床特征，并将数据与预期CAED的数据进行比较。方法：我们将意外CAED定义为非危重ED护理区域患者中发生的CA；归类为不需要严格监测。该分类是改良的日本分诊和敏锐度量表和医师评估。对2016年至2018年的病例进行回顾性分析，与其他经历CAED的患者相比。结果：本研究中的38例意外CA占ED诊断的CA的34.5％，占ED治疗的所有CA的8.4％。该人群在人口统计学方面与其他CAED没有显着差异，合并症,和存活率。最常见的症状是呼吸困难,意识障碍,广义弱点，和胸痛。最常见的死亡原因是急性心肌梗死，恶性肿瘤转移，感染性休克,肺栓塞,和心力衰竭。结论：意外CAED代表一组潜在可避免的CA和死亡。应该对这些病人进行分析,ED管理应包括旨在减少其发病率的措施。
