ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG, NGUYÊN NHÂN VÀ KẾT CỤC CỦA NGƯỜI BỆNH NGƯNG TIM NGOẠI VIỆN TẠI KHOA CẤP CỨU BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Background: Out-of-hospital cardiac arrest (OHCA) is one of the most critical conditions in medical practice. The survival rate and the rate of return of spontaneous circulation (ROSC) remain low. Understanding the clinical features, subclinical characteristics, causes and outcomes in this patient group can enhance our knowledge of the prevalence of cardiac arrest occurring outside the hospital and provide additional clinical data to improve patient treatment. Objective: To describe the clinical features, subclinical characteristics, causes and outcomes in patients with out-of-hospital cardiac arrest. Method: A cross-sectional descriptive study was conducted on patients with out-of-hospital cardiac arrest from December 2021 to August 2024. Results: A total of 93 patients with out-of-hospital cardiac arrest were analyzed. The average age was 66.86 ± 15.9 years. Dyspnea was a common symptom recorded before cardiac arrest, affecting 66.3% of patients. Additionally, a history of chronic disease was present in 90.3% of the patients. Among those who experienced OHCA, 89.24% had a witness present; however, no cases were recorded in which bystanders performed cardiopulmonary resuscitation (CPR). The most common location for cardiac arrest was in a private vehicle while en route to the hospital. Cardiovascular disease was identified as the leading cause of cardiac arrest, accounting for 44.08%. In our study, the rate of ROSC was nearly 57%, while only 9.68% of patients were conscious at discharge. The cut-off point for the time from cardiac arrest to CPR (No-flow: NF) was 15 minutes, with an AUC of 0.597 (95% CI: 0.455-0.738), and the CPR duration (Low-flow: LF) cut-off was 36 minutes, with an AUC of 0.929 (95% CI: 0.869-0.989). Conclusion: The most common location for cardiac arrest was in a private vehicle while on the way to the hospital. There were no cases of bystanders performing chest compressions. Cardiovascular disease was the leading cause of OHCA. The survival rate remained low, highlighting the importance of early cardiopulmonary resuscitation for improving patient outcomes. We identified a 15-minute no-flow cut-off time and a 36-minute low-flow cut-off time, both of which significantly impact patient prognosis.