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Prognostic factors on post cardiopulmonary cerebral resuscitation in general hospitals

By André Mansur de Carvalho Guanaes Gomes

Abstract

Realizamos este estudo com o objetivo de analisar as principais variáveis clínicas dos pacientes que sofreram parada cardiorrespiratória e detectar fatores prognósticos de sobrevivência a curto e longo prazos, tentando oferecer subsídios aos profissionais de saúde que estão envolvidos com reanimação. Analisamos prospectivamente 452 pacientes que receberam reanimação em hospitais gerais de Salvador. Utilizou-se análise bivariada e estratificada nas associações entre as variáveis e a curva de sobrevida para análise de nove anos de evolução. Observamos 24% de sobrevida imediata e 5% de sobrevida à alta hospitalar. Os fatores prognósticos de sobrevida imediata foram: ter doença de base, a enfermidade cardiovascular, diagnosticar o ritmo cardíaco , ritmo de fibrilação ou taquicardia ventricular, tempo estimado pré-reanimação menor ou igual a cinco minutos; tempo de reanimação menor ou igual a 15 minutos. As variáveis prognósticas sobrevida a longo prazo foram: não usar adrenalina; ser reanimado em hospital privado;tempo de reanimação menor ou igual a 15 minutosThe objectives of this study are to analyze the main clinical and demographic characteristics of patients who suffer cardiac arrest and identify variables involved in survival outcomes. The study enrolled 452 patients, which received cardiopulmonary resuscitation in general hospitals. We prospectively analyzed the main variables associated with ROSC and survival to hospital discharge utilizing bivariate and stratified. The Kaplan-Meier technique was used to analyze the survival curves after nine years. Of the 452 resuscitation attempts, 107 (24%) patients had ROSC and only 22 (5%) were discharge from hospital. The variables with greatest prognostic value for immediate survival were: having a co-morbid condition, cardiovascular disease as the etiology, determination of cardiac rhythm, ventricular arrhythmia as rhythm of arrest, estimated pre-resuscitation time less than or equal to 5 minutes and the resuscitation effort duration less than or equal to 15 minutes. The variables associated with better long term survival were: not using adrenaline, being resuscitated in a private hospital and resuscitation efforts lasting less than or equal to 15 minute

Topics: Parada cardíaca/epidemiologia, Sobrevivência, Salvador (BA), Estudos de coortes, Estudos transversais, Ressuscitação cardiopulmonar, Hospitais gerais, Prognóstico, Salvador (BA), Prognosis, Cardiopulmonary resuscitation, Heart arrest /epidemiology, General hospitals, Cross-sectional studies, Cohort studies, Survival
Publisher: 'Universidade de Sao Paulo, Agencia USP de Gestao da Informacao Academica (AGUIA)'
Year: 2014
DOI identifier: 10.11606/T.5.2004.tde-06102014-105945
OAI identifier: oai:teses.usp.br:tde-06102014-105945
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