Survival and neurologic outcome after traumatic out-of-hospital cardiopulmonary arrest in a pediatric and adult population a systematic review 英文参考文献.docVIP

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Survival and neurologic outcome after traumatic out-of-hospital cardiopulmonary arrest in a pediatric and adult population a systematic review 英文参考文献.doc

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Survival and neurologic outcome after traumatic out-of-hospital cardiopulmonary arrest in a pediatric and adult population a systematic review 英文参考文献

Zwingmannetal.CriticalCare2012,16:R117 /content/16/4/R117 RESEARCH OpenAccess Survivalandneurologicoutcomeaftertraumatic out-of-hospitalcardiopulmonaryarrestina pediatricandadultpopulation:asystematic review J?rnZwingmann*,AlexanderTMehlhorn,ThorstenHammer,J?rgBayer,NorbertPSüdkampandPeterCStrohm Abstract Introduction:Thissystematicreviewisfocusedonthein-hospitalmortalityandneurologicaloutcomeofsurvivors afterprehospitalresuscitationfollowingtrauma.Datawereanalyzedforadults/pediatricpatientsandforblunt/ penetratingtrauma. Methods:AsystematicreviewwasperformedusingthedataavailableinOvidMedline.476articlesfrom1/1964- 5/2011wereidentifiedbytwoindependentinvestigatorsand47studiesfulfilledtherequirements(admissionto hospitalafterprehospitalresuscitationfollowingtrauma).NeurologicaloutcomewasevaluatedusingtheGlasgow outcomescale. Results:34studies/5391patientswithapotentiallymixedpopulation(noinformationwasfoundinmoststudiesif andhowmanychildrenwereincluded)and13paediatricstudies/1243children(age≤18years)wereinvestigated. Theoverallmortalitywas92.8%(mixedpopulation:238survivors,lethality96.7%;paediatricgroup:237survivors, lethality86.4%=p0.001). Penetratingtraumawasfoundin19studies/1891patientsinthemixedpopulation(69survivors,lethality:96.4%) andin3pediatricstudies/91children(2survivorslethality97.8%). 44.3%ofthesurvivorsinthemixedpopulationand38.3%inthegroupofchildrenhadagoodneurologicalrecovery. Amoderatedisabilitycouldbeevaluatedin13.1%inthemixedpopulationandin12.8%inchildren.Asevere disabilitywasfoundin29.5%ofthesurvivorsinthemixedpatientsandin38.3%inthegroupofchildren.A persistentvegetativestatewastheneurologicalstatusin9.8%inthemixedpopulationandin10.6%inchildren. Foreachyearpriorto2010,theestimatedlog-oddsforsurvivaldecreasedby0.022(95%-CI:[0.038;0.006]).When jointlyanalyzingthestudiesonadultsandchildren,theproportionofsurvivorsforchildrenisestimatedtobe 17.8%(95%-CI:[15.1%;20.8%]).Thedifferenceofthepaediatriccomparedtotheadultproportionissignificant(p 0.001). Co