The Relationship Between Survival Prognosis And Characteristics Of Infetion Of Post-resuscitation Syndrome In Adult Patients With Sudden Death Outside The Hospital

Objective:To explore the relationship between the survival prognosis and the characteristics of infection in patientswith sudden death outside the hospital with spontaneous circulation of stay during the ICU,and to provide clues for prevention and control of these patients.Methods: Retrospective analysis of January 1,2012 to August 31,2016out-of-hospital sudden death of adults,to return of spontaneous circulation(ROSC)and survival ≥ 3 days,admittedto the ICU at the First Affiliated Hospital of Guangxi Medical University,a total of 63 cases were included in the inclusion criteria.Analysis of baseline data and infection characteristics of patients,includinginfectionsite,degree ofinfection,pathogen characteristics.Logisticregression was used to analyze the relationship between sex,age,sudden death,GCS score,APACHEⅡscore,whether infection,whether the drug resistance and death or survival prognosis of stay for 28 days.Results:The age of the patients was 15~88(52.81±17.65)years old;the average hospital stay was(23.44±29.41)days;the main Infection site was below the respiratory tract and / or other parts of infection sites,accounting for 87.30%,followed by the urinary tract,blood,and the rest.A total of 150 specimens,of which 103 were positive and 75(72.82%)were confirmed as pathogens according to commonly accepted standard.Among75 pathogens there were 54 strains(72.00%)in the endotracheal intubation or lavage fluid specimen,15 strains(20.00%)of urine samples,4 strains(5.33%)of blood samples and 2 strains(2.67%)of other specimens.36 strains were gram-negativebacteria(48.00%),the top 4 were:Acinetobacter baumannii,Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli.The most common gram-positive organismsand fungi were Staphylococcus aureus andCandida albicans.There were multiple drug resistance in Acinetobacter baumannii(13,92.31%).Multivariate analysis showed that infection,low GCS score and high APACHEⅡ score were the independent factors in increasing mortality(infection:P=0.043,OR=1.410;GCSscore:P=0.006,OR=0.696;APACHEⅡscore: P=0.020,OR=1.218),however,there were no statistically significant differences among sex,age,sudden death of the causeand whether drug resistant(P>0.05),which hadno significant effect on prognosis.Conclusions:The adult patients who occurred out-of-hospital sudden death were mainly infected by pulmonary infection after ROSC,and the most common pathogens were gram negative bacilli,and there exist multiple drug resistance phenomenon;infection,low GCS score and high APACHEⅡscore were the significant indicators for predicting28 days mortality.