Saraschandra Vallabhajosyula1, Saarwaani Vallabhajosyula2, Malcolm R Bell2, Abhiram Prasad2, Mandeep Singh2, Roger D White3, Allan S Jaffe2, David R Holmes2, Jacob C Jentzer4. 1. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States; Center for Clinical and Translational Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States. Electronic address: Vallabhajosyula.Saraschandra@mayo.edu. 2. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States. 3. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States; Division of Cardiovascular Anesthesia, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States. 4. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States.
Abstract
BACKGROUND: There are limited data on the timing and outcomes of in-hospital cardiac arrest (IHCA) in patients with ST-elevation myocardial infarction (STEMI) receiving primary percutaneous coronary intervention (pPCI). This study sought to examine the in-hospital mortality, temporal trends and resource utilization in early vs. delayed IHCA in STEMI. METHODS: Retrospective cohort study from the National Inpatient Sample of all STEMI admissions during 2000-2014 receiving pPCI on hospital day zero. Admissions transferred from other hospitals, with do-not-resuscitate status, without information on IHCA timing, and receiving surgical revascularization were excluded. IHCA was classified as early (hospital day zero) and delayed (on/after hospital day 1). The primary outcome was in-hospital mortality and secondary outcomes included prevalence, temporal trends, and resource utilization. RESULTS: During this 15-year period, 19,185 admissions met the inclusion criteria, with 15,404 (80%) experiencing an early IHCA. The cohort with delayed IHCA was on average older, female, with higher comorbidity, and greater prevalence of non-shockable rhythms and acute organ failure. There was a temporal increase in early IHCA (adjusted odds ratio [aOR] 1.67 [95% confidence interval {CI} 1.35-2.08]) and a decrease in delayed IHCA (aOR 0.60 [95% CI 0.48-0.74]) in 2014 compared to 2000. Compared to the early IHCA cohort, the delayed IHCA cohort had higher in-hospital mortality (aOR 5.35 [95% CI 4.83-5.94]), higher hospitalization costs ($115,165 ± 109,848 vs. 139,038 ± 142,745) and less frequent discharges to home (74% vs. 52%). CONCLUSIONS: Delayed IHCA (on or after hospital day 1) was associated with higher in-hospital mortality and resource utilization compared to early IHCA.
BACKGROUND: There are limited data on the timing and outcomes of in-hospital cardiac arrest (IHCA) in patients with ST-elevation myocardial infarction (STEMI) receiving primary percutaneous coronary intervention (pPCI). This study sought to examine the in-hospital mortality, temporal trends and resource utilization in early vs. delayed IHCA in STEMI. METHODS: Retrospective cohort study from the National Inpatient Sample of all STEMI admissions during 2000-2014 receiving pPCI on hospital day zero. Admissions transferred from other hospitals, with do-not-resuscitate status, without information on IHCA timing, and receiving surgical revascularization were excluded. IHCA was classified as early (hospital day zero) and delayed (on/after hospital day 1). The primary outcome was in-hospital mortality and secondary outcomes included prevalence, temporal trends, and resource utilization. RESULTS: During this 15-year period, 19,185 admissions met the inclusion criteria, with 15,404 (80%) experiencing an early IHCA. The cohort with delayed IHCA was on average older, female, with higher comorbidity, and greater prevalence of non-shockable rhythms and acute organ failure. There was a temporal increase in early IHCA (adjusted odds ratio [aOR] 1.67 [95% confidence interval {CI} 1.35-2.08]) and a decrease in delayed IHCA (aOR 0.60 [95% CI 0.48-0.74]) in 2014 compared to 2000. Compared to the early IHCA cohort, the delayed IHCA cohort had higher in-hospital mortality (aOR 5.35 [95% CI 4.83-5.94]), higher hospitalization costs ($115,165 ± 109,848 vs. 139,038 ± 142,745) and less frequent discharges to home (74% vs. 52%). CONCLUSIONS: Delayed IHCA (on or after hospital day 1) was associated with higher in-hospital mortality and resource utilization compared to early IHCA.
Authors: Saraschandra Vallabhajosyula; Viral K Desai; Pranathi R Sundaragiri; Wisit Cheungpasitporn; Rajkumar Doshi; Vikas Singh; Allan S Jaffe; Amir Lerman; Gregory W Barsness Journal: Ann Transl Med Date: 2021-07
Authors: Saraschandra Vallabhajosyula; Saarwaani Vallabhajosyula; Shannon M Dunlay; Sharonne N Hayes; Patricia J M Best; Jorge A Brenes-Salazar; Amir Lerman; Bernard J Gersh; Allan S Jaffe; Malcolm R Bell; David R Holmes; Gregory W Barsness Journal: Mayo Clin Proc Date: 2020-09 Impact factor: 7.616
Authors: Saraschandra Vallabhajosyula; Lina Ya'Qoub; Mandeep Singh; Malcolm R Bell; Rajiv Gulati; Wisit Cheungpasitporn; Pranathi R Sundaragiri; Virginia M Miller; Allan S Jaffe; Bernard J Gersh; David R Holmes; Gregory W Barsness Journal: Circ Heart Fail Date: 2020-09-29 Impact factor: 8.790
Authors: Saraschandra Vallabhajosyula; Stephanie R Payne; Jacob C Jentzer; Lindsey R Sangaralingham; Kianoush Kashani; Nilay D Shah; Abhiram Prasad; Shannon M Dunlay Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2021-02-08
Authors: Saraschandra Vallabhajosyula; Jacob C Jentzer; Abhiram Prasad; Lindsey R Sangaralingham; Kianoush Kashani; Nilay D Shah; Shannon M Dunlay Journal: ESC Heart Fail Date: 2021-04-09
Authors: Saraschandra Vallabhajosyula; Shiva P Ponamgi; Sanskriti Shrivastava; Pranathi R Sundaragiri; Virginia M Miller Journal: FASEB J Date: 2020-07 Impact factor: 5.191
Authors: Saraschandra Vallabhajosyula; Sri Harsha Patlolla; P Elliott Miller; Wisit Cheungpasitporn; Allan S Jaffe; Bernard J Gersh; David R Holmes; Malcolm R Bell; Gregory W Barsness Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2020-06-12
Authors: Saraschandra Vallabhajosyula; Aditi Shankar; Sri Harsha Patlolla; Abhiram Prasad; Malcolm R Bell; Jacob C Jentzer; Shilpkumar Arora; Saarwaani Vallabhajosyula; Bernard J Gersh; Allan S Jaffe; David R Holmes; Shannon M Dunlay; Gregory W Barsness Journal: ESC Heart Fail Date: 2020-04-02