Phani Kantamineni1, Vamsi Emani, Ankur Saini, Hardeep Rai, Abhijit Duggal. 1. Department of Internal Medicine (PK, VE, AS), ValleyCare Health System/NEOMED, Northside Medical Center, Youngstown, Ohio; and Medical Intensive Care Unit (HR, AD), Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
Abstract
BACKGROUND: A better understanding of the factors affecting the outcome of inpatient cardiopulmonary resuscitation (CPR) is crucial in making key clinical decisions. We aim to study the impact of various patient-related and hospital-related variables in a community-based teaching setup that could affect the prognosis of in-hospital cardiac arrests. METHODS: We analyzed the data on all patients who experienced cardiac arrest while hospitalized at a community teaching hospital in Youngstown, Ohio. A multivariable logistic regression was performed to identify patient- and system-based variables associated with mortality in inpatient cardiac arrest. RESULTS: A total of 417 in-hospital cardiopulmonary arrests were recorded during the study period. We analyzed 299 events in our final sample. One hundred sixty-four patients (54.8%) achieved return of spontaneous circulation and 137 (48.5%) survived the cardiopulmonary arrest for at least 24 hours. The duration of CPR, age, initial rhythm, witnessed events and sex were strongly associated with mortality in our univariate analysis. After adjustment for age, location and whether the code was witnessed, the timing of the week, initial rhythm, the duration of CPR and the sex of the patient retained prognostic significance in predicting the mortality. CONCLUSIONS: In our study, we report a 17.4% survival to hospital discharge after an in-hospital cardiopulmonary arrest and subsequent CPR, similar to rates reported in larger multicenter studies. Prolonged duration of CPR (>10 minutes) and male sex were found to be associated with worse outcomes. We report the impact of system-based variables such as physician and nursing staffing during different days of the week, on survival in these patients.
BACKGROUND: A better understanding of the factors affecting the outcome of inpatient cardiopulmonary resuscitation (CPR) is crucial in making key clinical decisions. We aim to study the impact of various patient-related and hospital-related variables in a community-based teaching setup that could affect the prognosis of in-hospital cardiac arrests. METHODS: We analyzed the data on all patients who experienced cardiac arrest while hospitalized at a community teaching hospital in Youngstown, Ohio. A multivariable logistic regression was performed to identify patient- and system-based variables associated with mortality in inpatient cardiac arrest. RESULTS: A total of 417 in-hospital cardiopulmonary arrests were recorded during the study period. We analyzed 299 events in our final sample. One hundred sixty-four patients (54.8%) achieved return of spontaneous circulation and 137 (48.5%) survived the cardiopulmonary arrest for at least 24 hours. The duration of CPR, age, initial rhythm, witnessed events and sex were strongly associated with mortality in our univariate analysis. After adjustment for age, location and whether the code was witnessed, the timing of the week, initial rhythm, the duration of CPR and the sex of the patient retained prognostic significance in predicting the mortality. CONCLUSIONS: In our study, we report a 17.4% survival to hospital discharge after an in-hospital cardiopulmonary arrest and subsequent CPR, similar to rates reported in larger multicenter studies. Prolonged duration of CPR (>10 minutes) and male sex were found to be associated with worse outcomes. We report the impact of system-based variables such as physician and nursing staffing during different days of the week, on survival in these patients.
Authors: Martin Christ; Wolfgang Dierschke; Katharina Isabel von Auenmueller; Marc van Bracht; Martin Grett; Hans-Joachim Trappe Journal: Int J Gen Med Date: 2014-06-30
Authors: Abdullah Mohammed Kaki; Kamal Waheeb Alghalayini; Mohamed Nabil Alama; Adnan Abdullah Almazroaa; Norah Abdullah A Khathlan; Hassan Sembawa; Beena M Ouseph Journal: Saudi J Anaesth Date: 2017 Oct-Dec