Giulio Radeschi1, Andrea Mina2, Giacomo Berta3, Andrea Fassiola4, Agostino Roasio5, Felice Urso6, Roberto Penso3, Ugo Zummo7, Paola Berchialla8, Giuseppe Ristagno9, Claudio Sandroni10. 1. Anaesthesia and Operating Room Unit, Cottolengo Hospital, Turin, Italy; Scientific Committee of the Regional Board for In-hospital Emergencies, Piedmont Region, Italy. 2. Scientific Committee of the Regional Board for In-hospital Emergencies, Piedmont Region, Italy; Department of Anaesthesia and Intensive Care, S. Giovanni Battista Hospital, Turin, Italy. 3. Scientific Committee of the Regional Board for In-hospital Emergencies, Piedmont Region, Italy; Anaesthesia and Intensive Care Unit, San Luigi Hospital, Orbassano, Turin, Italy. 4. Scientific Committee of the Regional Board for In-hospital Emergencies, Piedmont Region, Italy; Anaesthesia and Intensive Care Unit, Sant'Andrea Hospital, Vercelli, Italy. 5. Scientific Committee of the Regional Board for In-hospital Emergencies, Piedmont Region, Italy; Anaesthesia and Intensive Care Unit, Cardinal Massaia Hospital, Asti, Italy. 6. Scientific Committee of the Regional Board for In-hospital Emergencies, Piedmont Region, Italy; Anaesthesia and Intensive Care Unit, San Giovanni Bosco Hospital, Turin, Italy. 7. Scientific Committee of the Regional Board for In-hospital Emergencies, Piedmont Region, Italy; Anaesthesia and Intensive Care Unit, SS. Annunziata Hospital, Savigliano, Italy. 8. Department of Clinical and Biological Sciences, University of Turin, Italy. 9. IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy; Italian Resuscitation Council, Bologna, Italy. 10. Department of Anaesthesiology and Intensive Care, Università Cattolica del Sacro Cuore, Policlinico Universitario Agostino Gemelli, Rome, Italy. Electronic address: sandroni@rm.unicatt.it.
Abstract
AIMS: to report the incidence, characteristics, and outcome of in-hospital cardiac arrest (IHCA) in a large Italian region. SETTING: all hospitals participating in the IHCA Registry Initiative of Piedmont. METHODS: observational cohort study in adult (>18year old) inpatients resuscitated from IHCA during three consecutive years (2012-2014). The main outcome measures were IHCA incidence and survival to hospital discharge. RESULTS: A total of1539 arrests in adult inpatients were recorded in the study period, yielding an overall incidence of 1.51 arrests/1000 admissions. The incidence was highest at day 1 after hospital admission and in the morning hours, with a peak at 9.00 a.m. Median age was 77 (interquartile range 68-83) years. The presenting rhythm was ventricular fibrillation/pulseless ventricular tachycardia in 291/1539 (18.9%) cases. A total of 549/1539 (35.7%) patients achieved recovery of spontaneous circulation (ROSC) and 228/1539(14.8%) survived hospital discharge, with 207 (90.8%) of the latter having good neurological outcome (Cerebral Performance Categories [CPC] 1 or 2).After adjustment for major confounders, a pre-arrest CPC=1, a cardiac cause of arrest, a shockable presenting rhythm, and a shorter duration of resuscitation were independently associated with a higher likelihood of survival to discharge. CONCLUSIONS: in this Italian registry the incidence of IHCA and its circadian distribution were comparable to those in the NCAA registry in the UK. Patients were older and had a lower ROSC rate than these observed in other large IHCA registries, but post-ROSC survival rate and factors affecting survival to discharge were similar.
AIMS: to report the incidence, characteristics, and outcome of in-hospital cardiac arrest (IHCA) in a large Italian region. SETTING: all hospitals participating in the IHCA Registry Initiative of Piedmont. METHODS: observational cohort study in adult (>18year old) inpatients resuscitated from IHCA during three consecutive years (2012-2014). The main outcome measures were IHCA incidence and survival to hospital discharge. RESULTS: A total of1539 arrests in adult inpatients were recorded in the study period, yielding an overall incidence of 1.51 arrests/1000 admissions. The incidence was highest at day 1 after hospital admission and in the morning hours, with a peak at 9.00 a.m. Median age was 77 (interquartile range 68-83) years. The presenting rhythm was ventricular fibrillation/pulseless ventricular tachycardia in 291/1539 (18.9%) cases. A total of 549/1539 (35.7%) patients achieved recovery of spontaneous circulation (ROSC) and 228/1539(14.8%) survived hospital discharge, with 207 (90.8%) of the latter having good neurological outcome (Cerebral Performance Categories [CPC] 1 or 2).After adjustment for major confounders, a pre-arrest CPC=1, a cardiac cause of arrest, a shockable presenting rhythm, and a shorter duration of resuscitation were independently associated with a higher likelihood of survival to discharge. CONCLUSIONS: in this Italian registry the incidence of IHCA and its circadian distribution were comparable to those in the NCAA registry in the UK. Patients were older and had a lower ROSC rate than these observed in other large IHCA registries, but post-ROSC survival rate and factors affecting survival to discharge were similar.
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