Correlation of the predictive ability of early warning metrics and mortality for cardiac arrest patients receiving in-hospital Advanced Cardiovascular Life Support

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• 作者：Barbara DeVoe ; DNP ; FNP-BC^a ; ¹ ; Anita Roth ; MS^b ; Gregory Maurer ; PA-C^c ; Michal Tamuz ; PhD^d ; Martin Lesser ; PhD^e ; Renee Pekmezaris ; PhD^f ; ^g ; Amgad N. Makaryus ; MD^h ; ⁱ ; Alan Hartman ; MD^j ; Paola DiMarzio ; PhD ; MPH^f ; ^g ; ¹ ; ^{pdimarzi@nshs.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cardiac arrest ; Cardiac rhythm ; Advanced cardiovascular life support ; MEWS ; Survival
• 刊名：Heart & Lung: The Journal of Acute and Critical Care
• 出版年：2016
• 出版时间：November-December 2016
• 年：2016
• 卷：45
• 期：6
• 页码：497-502
• 全文大小：448 K

文摘

The Modified Early Warning Score (MEWS) helps identify patients experiencing a decline in physiological parameters that indicate risk for cardiac arrest (CA).

Objectives

To assess the association between MEWS values and patient survival following in-hospital CA.

Methods

Retrospective cohort study of patients who experienced in-hospital CA. The relationship between CA survival and MEWS values as well as other risk factors such as age, gender and type of electrographic cardiac rhythms was analyzed using logistic regression.

Results

Survival rate to hospital discharge was 21%. Strong predictors for survival were MEWS values at hospital admission (p < .002), younger age (p < .005), ventricular fibrillation (p < .0001), and ventricular tachycardia (p < .0001). Gender and MEWS 4 hours prior to CA were not significantly associated with survival.

Conclusions

Survival following CA was significantly associated with MEWS at hospital admission but not 4 hours prior to CA. The type of cardiac rhythm and age were also predictive of survival.