We sought to investigate the relationship between mechanical cardiopulmonary resuscitation (CPR) during in-hospital cardiac arrest and survival to hospital discharge. Utilizing the prospectively collected American Heart Association’s Get With The Guidelines database, we performed an observational study. Data from 153 institutions across the United States were reviewed with a total of 351,125 patients suffering cardiac arrest between 2011 and 2019 were screened. After excluding patients with cardiac arrests lasting less than 5 minutes, and patients who had incomplete data, a total of 111,143 patients were included. Our primary exposure was mechanical vs. manual CPR, and the primary outcome was survival to hospital discharge. Multivariate logistic regression models and propensity weighted analyses were used. 11.8% of patients who received mechanical CPR survived to hospital discharge versus 16.9% in the manual CPR group. Patients who received mechanical CPR had a lower probability of survival to discharge compared to patients who received manual CPR (OR 0.66 95% CI 0.58-0.75; p < 0.001). This association persisted with multi-variable adjustment (OR 0.57 95% CI 0.46-0.70, p<0.0001) and propensity weighted analysis (OR 0.68 95% CI 0.44-0 .92, p< 0.0001). Mechanical CPR was associated with decrease likelihood of return of spontaneous circulation after multivariate adjustment (OR 0.68, 95% CI 0.60-0.76; p < 0.001). Mechanical CPR was associated with a decreased likelihood of survival to hospital discharge and ROSC compared to manual CPR. This finding should be interpreted within the context of important limitations of this study and randomized trials are needed to better investigate this relationship.

中文翻译：

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机械心肺复苏与院内心脏骤停结果之间的关联：一项观察性队列研究

我们试图调查院内心脏骤停期间的机械心肺复苏（CPR）与出院存活率之间的关系。利用前瞻性收集的美国心脏协会的 Get With TheGuidelines 数据库，我们进行了一项观察性研究。审查了美国 153 个机构的数据，对 2011 年至 2019 年间总共 351,125 名心脏骤停患者进行了筛查。排除心脏骤停持续时间小于5分钟的患者以及数据不完整的患者后，总共纳入111,143例患者。我们的主要暴露是机械心肺复苏与手动心肺复苏，主要结局是出院存活率。使用多变量逻辑回归模型和倾向加权分析。接受机械心肺复苏的患者有 11.8% 存活到出院，而手动心肺复苏组的存活率为 16.9%。与接受手动 CPR 的患者相比，接受机械 CPR 的患者出院后的生存概率较低（OR 0.66 95% CI 0.58-0.75；p < 0.001）。这种关联在多变量调整（OR 0.57 95% CI 0.46-0.70，p < 0.0001）和倾向加权分析（OR 0.68 95% CI 0.44-0 .92，p < 0.0001）中持续存在。多变量调整后，机械心肺复苏与自主循环恢复的可能性降低相关（OR 0.68，95% CI 0.60-0.76；p < 0.001）。与手动心肺复苏相比，机械心肺复苏与出院生存和自主循环恢复的可能性降低相关。这一发现应在本研究的重要局限性的背景下进行解释，并且需要随机试验来更好地研究这种关系。