Acil Servise Arrest Nedeniyle Getirilen Hastalarda İlk Tespit Edilen Kardiyak Ritmin Sağkalım Üzerine Olan Etkisinin Araştırılması

Öz

ÖZ Amaç: Kardiyopulmoner arrest, dolaşım ve solunum fonksiyonlarının aniden durması sonucu dokulara yetersiz oksijen taşınması durumudur. Bu çalışmada kardiyopulmoner arrest ile başvuran hastalarda arrest nedenlerini ve başlangıç kardiyak ritminin hasta sağkalımına etkisini araştırmayı amaçladı. Gereç ve Yöntem: Geriye dönük olarak yapılan bu çalışmaya, hastane içi ve hastane dışı kardiyak arrest geçiren ve acil servisimize başvuran 1126 hastadan dışlama kriterleri sonrasında 1009'u dahil edildi. Hastaların demografik özelliklerinin yanı sıra başlangıç ritimleri ve mortalite durumları değerlendirildi. Bulgular: Hastaların klinik sonuçları ile başlangıç kardiyak ritimleri arasında anlamlı bir ilişki vardı (p<0.001). Başlangıçta kalp ritmi asistoli olan hastalarda mortalite oranı (%77,1) daha yüksekti. Yatan hastalarda asidoz oranı daha yüksek iken, ölümlü hastalarda travma oranı daha yüksekti (p<0.001). Kalp ritmi dönen hastalarda ST elevasyonu, ölenlerde sağ dal bloğu daha fazlaydı ancak bunlar istatistiksel olarak anlamlı değildi. Sonuç: Arrest hastalarında ilk ritim analizi, özellikle şoklanabilir ritimler olan ventriküler fibrilasyon ve nabızsız ventriküler taşikardinin saptanmasında çok önemlidir ve erken tanı ve müdahale ile hasta sağkalımı artar.

Anahtar Kelimeler

• Kardiyopulmoner arrest
• kardiyak ritim
• mortalite

Investigation of the Effect of Initial Cardiac Rhythm on Survival in Patients Admitted with Cardiopulmonary Arrest to the Emergency Department

Öz

Objective: Cardiopulmonary arrest is the condition of insufficient oxygen delivery to tissues as a result of sudden cessation of circulatory and respiratory functions. This study aimed to investigate the causes of arrest in patients admitted with cardiopulmonary arrest and the effect of initial cardiac rhythm on patient survival. Material and Methods: Out of 1126 patients who had an in-hospital and out-of-hospital cardiac arrest and were admitted to our emergency department, 1009 patients were included in this retrospective study following the exclusion criteria. In addition to the demographic characteristics of patients, their initial rhythms and mortality states were assessed. Results: There was a significant relationship between patients’ clinical outcomes and initial cardiac rhythms (p<0.001). The mortality rate (77.1%) was higher in patients whose initial cardiac rhythm was asystole. While the rate of acidosis was higher in inpatients the rate of trauma was higher in mortal patients (p<0.001). ST elevation was higher in patients whose cardiac rhythm returned and right bundle branch block was higher in those who died, however, these were not statistically significant. Conclusion: The initial rhythm analysis in arrest patients is crucial specifically in the detection of ventricular fibrillation and pulseless ventricular tachycardia which are shockable rhythms and patient survival increases with early diagnosis and intervention.

Anahtar Kelimeler

• Cardiopulmonary arrest
• cardiac rhythm
• mortality

Kaynakça

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