心源性院内心搏骤停患者自主循环恢复的现状及影响因素研究

doi:10.3761/j.issn.2096-7446.2025.12.003

Abstract

Abstract:

Objective To explore the relevant influencing factors of spontaneous circulation recovery in patients with cardiogenicin-hospital cardiac arrest，and provide reference for preventing cardiac arrest and improving the success rate of rescue. Methods A retrospective analysis was conducted to continuously collect clinical data of 95 patients with cardiogenic in-hospital cardiac arrest admitted to a tertiary class A hospital in Zhenjiang City from May 2019 to May 2024. Based on the rescue outcomes，the patients were divided into a group with return of spontaneous circulation（ROSC） and a group without ROSC. Multivariate logistic regression analysis was conducted to explore the influencing factors. Results Among the 95 patients，61 recovered spontaneous circulation and 34 did not，with a success rate of 64.2%. Logistic regression analysis showed that premature contractions（OR=4.924，95% CI：1.368-17.723，P=0.015），nighttime（OR=4.805，95%CI：1.258-18.357，P=0.022），and cardiopulmonary resuscitation duration>15 minutes（OR=13.049，95%CI：1.424-119.602，P=0.023） were risk factors for spontaneous circulation recovery in patients with in-hospital cardiac arrest. Initial chest tightness and chest pain symptoms（OR=0.222，95% CI：0.057-0.864，P=0.030），tracheal intubation（OR=0.051，95%CI：0.009-0.282，P=0.001） were protective factors for the recovery of spontaneous circulation in patients with in-hospital cardiac arrest. Conclusion The success rate of ROSC in patients with cardiogenic in-hospital cardiac arrest is relatively low. Nursing staff should pay attention to patients with initial symptoms such as chest tightness and chest pain，and premature contractions before cardiac arrest. The professional strength of night shift nurses should be strengthened to increase the frequency of patrols，timely detect symptoms and arrhythmias of cardiac arrest，and activate rapid emergency teams to improve the success rate of ROSC for cardiogenic in-hospital cardiac arrest patients.

Key words: Cardiogenic, In-Hospital Cardiac Arrest, Return of Spontaneous Circulation, Influencing Factors, In-Hospital Emergency Treatment

LI Titi, WANG Mingming, REN Shuwen, WANG Peng, WU Zhengnan, CHEN Hongfang. Analysis of influencing factors on the recovery of spontaneous circulation in patients with cardiogenic in-hospital cardiac arrest[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(12): 1431-1436.

Figures/Tables 3

References 28

[1]	Andersen LW, Holmberg MJ, Berg KM, et al. In-hospital cardiac arrest[J]. JAMA, 2019, 321(12):1200. doi: 10.1001/jama.2019.1696 pmid: 30912843
[2]	中国心脏骤停与心肺复苏报告编写组. 中国心脏骤停与心肺复苏报告(2022年版)概要[J]. 中国循环杂志, 2023, 38(10):1005-1017.
	The Writing Committee of the Report on Cardiac Arrest and Cardiopulmonary Resuscitation in China. Report on cardiac arrest and cardiopulmonary resuscitation in China(2022):a summary[J]. Chin Circ J,2023, 38(10):1005-1017.
[3]	Gräsner JT, Herlitz J, Tjelmeland IBM, et al. European resuscitation council guidelines 2021:epidemiology of cardiac arrest in Europe[J]. Resuscitation, 2021,161:61-79.
[4]	Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics-2022 update:a report from the American Heart Association[J]. Circulation, 2022, 145(8):e153-e639.
[5]	Rattananon P, Tienpratarn W, Yuksen C, et al. Associated factors of cardiopulmonary resuscitation outcomes;a cohort study on an adult in-hospital cardiac arrest registry[J]. Arch Acad Emerg Med, 2024, 12(1):e30. doi: 10.22037/aaem.v12i1.2227 pmid: 38572213
[6]	刘肖, 王聪. 急诊猝死患者的心肺复苏时间情况调查及影响因素分析[J]. 中国医刊, 2023, 58(8):891-894.
	Liu X, Wang C. Investigation on the duration of cardiopulmonary resuscitation in emergency sudden death patients and analysis of influencing factors[J]. Chin J Med, 2023, 58(8):891-894.
[7]	Zhang YP, Rao CJ, Ran X, et al. How to predict the death risk after an in-hospital cardiac arrest(IHCA) in intensive care unit? A retrospective double-centre cohort study from a tertiary hospital in China[J]. BMJ Open, 2023, 13(10):e074214. doi: 10.1136/bmjopen-2023-074214
[8]	Nolan JP, Berg RA, Andersen LW, et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports:update of the utstein resuscitation registry template for in-hospital cardiac arrest:a consensus report from a task force of the international liaison committee on resuscitation(American Heart Association,European Resuscitation Council,Australian and New Zealand Council on Resuscitation,Heart and Stroke Foundation of Canada,InterAmerican Heart Foundation,Resuscitation Council of Southern Africa,Resuscitation Council of Asia)[J]. Circulation, 2019, 140(18):e746-e757.
[9]	赵嘉艺, 曾德华, 朱爱群. 成人院内心搏骤停预后影响因素[J]. 中华危重病急救医学, 2024, 36(4):398-403.
	Zhao JY, Zeng DH, Zhu AQ. Analysis of the factors influencing prognosis of the adult in-hospital cardiac arrest[J]. Chin Crit Care Med, 2024, 36(4):398-403.
[10]	Marijon E, Uy-Evanado A, Dumas F, et al. Warning symptoms are associated with survival from sudden cardiac arrest[J]. Ann Intern Med, 2016, 164(1):23-29. doi: 10.7326/M14-2342 pmid: 26720493
[11]	Nehme Z, Bernard S, Andrew E, et al. Warning symptoms preceding out-of-hospital cardiac arrest:Do patient delays matter?[J]. Resuscitation, 2018,123:65-70.
[12]	Zheng K, Bai Y, Zhai QR, et al. Correlation between the warning symptoms and prognosis of cardiac arrest[J]. World J Clin Cases, 2022, 10(22):7738-7748. doi: 10.12998/wjcc.v10.i22.7738 pmid: 36158514
[13]	李东泽, 刘伯夫, 周法庭, 等. 《2021年AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR胸痛评估与诊断指南》解读[J]. 华西医学, 2021, 36(11):1488-1496.
	Li DZ, Liu BF, Zhou FT, et al. Interpretation of 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain[J]. West China Med J, 2021, 36(11):1488-1496.
[14]	Thiele H, Jobs A. ESC guidelines 2020:acute coronary syndrome without persistent ST-segment elevation:what is new?[J]. Herz, 2021, 46(1):3-13. doi: 10.1007/s00059-020-05002-1
[15]	White L, Melhuish T, Holyoak R, et al. Advanced airway management in out of hospital cardiac arrest:a systematic review and meta-analysis[J]. Am J Emerg Med, 2018, 36(12):2298-2306. doi: 10.1016/j.ajem.2018.09.045
[16]	Wang CH, Wu MC, Wu CY, et al. Blood gas phenotyping and tracheal intubation timing in adult in-hospital cardiac arrest:a retrospective cohort study[J]. Sci Rep, 2021, 11(1):10480. doi: 10.1038/s41598-021-89920-y
[17]	Carlson JN, Wang HE. Optimal airway management in cardiac arrest[J]. Crit Care Clin, 2020, 36(4):705-714. doi: S0749-0704(20)30050-6 pmid: 32892823
[18]	Panchal AR, Bartos JA, Cabañas JG, et al. Part 3:adult basic and advanced life support:2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care[J]. Circulation, 2020, 142(16_suppl_2):S366-S468.
[19]	徐胜勇, 于学忠, 徐军. 胸外按压持续时间与心肺复苏结局关系研究[J]. 临床急诊杂志, 2019, 20(8):623-626,631.
	Xu SY, Yu XZ, Xu J. The relationship between the duration of chest compression and the outcome of cardiopulmonary resuscitation[J]. J Clin Emerg, 2019, 20(8):623-626,631.
[20]	李红芳, 刘东玲, 杨飒, 等. 护士激活快速反应小组的标准及其影响因素的研究进展[J]. 护理学杂志, 2016, 31(21):103-106.
	Li HF, Liu DL, Yang S, et al. Criteria for activating a rapid response team by nursing staff and the influencing factor:a review[J]. J Nurs Sci, 2016, 31(21):103-106.
[21]	Soar J, Nolan JP, Böttiger BW, et al. European Resuscitation Council guidelines for resuscitation 2015:section 3. adult advanced life support[J]. Resuscitation, 2015,95:100-147.
[22]	中华医学会急诊医学分会, 中国老年医学学会急诊医学分会,中国老年心肺复苏急诊专家共识组. 中国老年心肺复苏急诊专家共识[J]. 临床急诊杂志, 2024, 25(5):213-220.
	Emergency Medicine Branch of Chinese Medical Association,Emergency Medicine Branch of Chinese Geriatrics Society, Emergency Experts Consensus Group on Cardiopulmonary Resuscitation in Elderly People. Emergency experts consensus on cardiopulmonary resuscitation in elderly people in China[J]. J Clin Emerg, 2024, 25(5):213-220.
[23]	徐伟, 林文风, 张洪辉, 等. 呼气末二氧化碳分压监测用于心肺复苏及预后评估研究[J]. 护理学杂志, 2023, 38(24):32-36.
	Xu W, Lin WF, Zhang HH, et al. Application of end-tidal carbon dioxide partial pressure monitoring in cardiopulmonary resuscitation and prognosis assessment[J]. J Nurs Sci, 2023, 38(24):32-36.
[24]	Provencio A, Gil MÁC. Smartwatch electrocardiogram records ST depression,premature ventricular complexes,and ventricular fibrillation[J]. Lancet, 2022, 400(10364):e12. doi: 10.1016/S0140-6736(22)01978-X pmid: 36366887
[25]	Baranger J, Mertens L, Villemain O. Blood flow imaging with ultrafast Doppler[J]. J Vis Exp, 2020(164).
[26]	李蓉, 宋潇, 赵瑞, 等. ST段下移、ST-T改变与房性或室性早搏的相关性[J]. 实用心电学杂志, 2024, 33(6):572-577,583.
	Li R, Song X, Zhao R, et al. Correlation between ST-segment depression,ST-T changes and atrial premature beats or premature ventricular contraction[J]. J Pract Electrocardiol, 2024, 33(6):572-577,583.
[27]	Musy SN, Endrich O, Leichtle AB, et al. The association between nurse staffing and inpatient mortality:a shift-level retrospective longitudinal study[J]. Int J Nurs Stud, 2021,120:103950.
[28]	Wu TT, Yang DL, Li H, et al. Development and validation of a nomogram to predict in-hospital cardiac arrest among patients admitted with acute coronary syndrome[J]. Am J Emerg Med, 2021,49:240-248.

Analysis of influencing factors on the recovery of spontaneous circulation in patients with cardiogenic in-hospital cardiac arrest

RichHTML

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 3

References 28

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	GU Xin, YANG Yanjie, PENG Hu, CAO Zhijie, MA Lina, ZHANG Li. Analysis on the status quo and influencing factors of post core competence of ICU nurses in Xinjiang [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 988-994.
[2]	JIANG Weilin, WANG Li, HUANG Zhenzhen, YAN Ran, YI Jia, ZHUANG Yiyu. Influencing factors of sleep disorders in post-ICU patients：a systematic review and meta-analysis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(8): 945-952.
[3]	CHEN Peng. Research progress of end tidal carbon dioxide monitoring in patients undergoing cardiopulmonary resuscitation [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(7): 891-896.
[4]	XU Yanan, LIU Yahui, WANG Danruo, KANG Yubiao, YUAN Ling. A meta-synthesis of the qualitative studies of the influencing factors of palliative care implemented by ICU medical staff [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(6): 737-743.
[5]	WANG Sa, YAN Danping, LIU Yajie, ZHOU Shuaishuai, WANG Meiling, LIN Gaoxing, XU Shurong, ZHOU Guangju, WANG Yuwei. Neuro-monitoring and nursing management practice during the low perfusion period in emergency cardiac arrest patients [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(6): 713-718.
[6]	HONG Liuyu, CHEN Xiangping, LAO Yuewen, CHEN Qianqian, GONG Xiaoyan. Research progress on influencing factors and intervention strategies of pediatric chronic critical illness [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(5): 566-569.
[7]	ZHANG Yueqi, WANG Youfang, PAN Meng, XIANG Xuan. The factors influencing unplanned endotracheal extubation in critically ill children：a meta-analysis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(5): 548-554.
[8]	FANG Bo, SHEN Zhijie, WANG Yan. Influencing factors of acute gastrointestinal injury in critically ill patients：a meta-analysis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(11): 1377-1385.
[9]	ZHANG Yufen, WANG Hui, HU Kaili, WU Qiansheng. Current situation and influencing factors of transitional care needs among patients after surgery for aortic dissection [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(11): 1328-1334.
[10]	QI Jianwei, LUO Yetao, ZHANG Kebiao, GU Manping, FU Shimin, MA Yingzhuo, JIANG Jing, LIU Min, ZHAO Qinghua. Status and influencing factors of workplace verbal abuse by patients among emergency nurses in 67 tertiary class A hospitals [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(10): 1232-1238.
[11]	CHEN Hailian, ZOU Shuang, LI Cheng, WANG Lihan. Perioperative nursing of emergency transcatheter aortic valve replacement for patients with severe aortic stenosis [J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(1): 79-81.
[12]	GUAN Qinling, LI Yao. Emergency nursing of a patient with out-of-hospital cardiac arrest rescued by the first eyewitness guided by remote video [J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(3): 235-237.
[13]	PAN Zhengwen, ZHOU Xiaoyu, ZHOU Weiwei, XU Liwei, ZHANG Jianli, YAN Yuexia. Research progress of medication self-management in patients with hematopoietic stem cell transplantation [J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(8): 760-764.
[14]	XIANG Yan, JIN Jingfen, WANG Lizhu , ZHU Yirong , SHAO Qing, LI Qian. Analysis of perception and attitude of family mem bers toward ICU patients’ early activities and its influencing factors [J]. Chinese Journal of Emergency and Critical Care Nursing, 2021, 2(4): 344-347.
[15]	ZHANG Yuying, LIN Ping, WANG Yini, ZHAO Zhenjuan, LIU Ying. Pathway analysis of influencing factors of acute stress disorder in patients with acute myocardial infarction [J]. Chinese Journal of Emergency and Critical Care Nursing, 2021, 2(1): 37-43.