复苏后良好结局评分2预测中国汉族人群院内心脏骤停患者神经系统预后的临床价值  

The clinical value of good outcome following attempted resuscitation 2 in predicting neurological prognosis of patients with in-hospital cardiac arrest in Chinese Han population

作　　者：黄霞 徐平[1,2] 程玲霞 任艳 高霞 殷国平 吴晓芳 曹灵红 叶利[3] HUANG Xia;XU Ping;CHENG Lingxia;REN Yan;GAO Xia;YIN Guoping;WU Xiaofang;CAO Linghong;YE Li(Department of Emergency,Zigong Fourth People's Hospital,Zigong Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院急诊科,四川自贡643000 [2]自贡市医学大数据与人工智能研究院医学大数据研究所,四川自贡643000 [3]富顺县人民医院急诊科,四川富顺643200

出　　处：《中国急救复苏与灾害医学杂志》2023年第3期289-293,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：人工智能四川省重点实验室开放基金项目(编号:2020RYY03);睿意急诊医学研究专项基金资助项目(编号:202013);自贡市科技计划项目(编号:2021YLSF29)。

摘　　要：目的评价复苏后良好结局评分2(GO-FAR2)在中国汉族人群预测院内心脏骤停患者神经系统预后的临床价值。方法连续性纳入2020年自贡市第四人民医院发生院内心脏骤停的患者进行回顾性分析,以GOFAR2评分四分位数为标准将研究对象分为Q1、Q2、Q3、Q4组,比较Q2、Q3、Q4组与Q1组出现脑功能分类评分≤2分(主要结局指标)的比值比,计算GO-FAR 2预测结局指标的受试者工作曲线下面积、绘制校正曲线。结果满足研究条件的成人患者共230例,神经系统预后良好(CPC评分≤2)25例(10.9%)。与Q1组相比较,GO-FAR2评分≥2组(Q2、Q3、Q4)OR值分别为0.48(95%CI:0.15~1.33)、0.18(95%CI:0.02~0.70)、0.28(95%CI:0.07~0.88)。GO-FAR2评分预测结局指标的ROC曲线下面积为0.664(95%CI:0.548~0.780)。GOFAR2评分预测结局指标预测值与真实值之间差异无统计学意义(Hosmwe-Lemeshow检验P值0.567)。结论GO-FAR2评分是中国汉族人群发生院内心脏骤停后预测出院后神经功能状态的简单、便捷且具有较强实用性的评价工具,值得进一步推广应用。Objective To verify the clinical value of Good outcome following attempted resuscitation 2(GO-FAR2)in predicting the nervous system outcome of in-hospital cardiac arrest(IHCA)in Chinese Han population.Methods Patients who suffered from IHCA during treatment in Zigong Fourth People's Hospital were included retrospectively.All the patients were divided into four groups(Q1,Q2,Q3 and Q4)according to the GO-FAR2 quartiles.The primary endpoint was cerebral performance category(CPC)≤2.Logistic regression models were used to estimate odd ratios(OR)with 95%confidential intervals(95%CI)of the primary endpoint by 4 groups,with the lowest quartile(Q1)as the reference group.The receiver operating characteristic(ROC)curve and the calibration curve were drawn for the primary endpoint.Results A total of 230 adult patients were included,and 10.9%of them had good neurological prognosis(CPC score≤2).Compared with Q1 group,ORs of Q2 group,Q3 group,Q4 group were 0.48(95%CI:0.15~1.33),0.18(95%CI:0.02~0.70),0.28(95%CI:0.07~0.88),respectively.The areas under the ROC curve of GO-FAR2 predicting the outcome of the patients were 0.664(95%CI:0.548~0.780).The Hosmwe-Lemeshow test showed that there was no statistical difference between the predicted outcome and the true outcome of GO-FAR2 score(P=0.567).Conclusion Go-FAR2 score is a simple,convenient and practical evaluation tool for predicting neurological status after discharge in Chinese Han population with IHCA,which is worthy of further promotion and application.

关 键 词：院内心脏骤停 神经系统预后 脑功能分类评分 复苏后良好结局评分2 校正曲线 

分 类 号：R605.97[医药卫生—急诊医学]