Zheng Jie Lim1, Mallikarjuna Ponnapa Reddy2, J Randall Curtis3,4, Afsana Afroz5,6, Baki Billah5, Vishad Sheth7, Salim S Hayek8, David E Leaf9, Jeremy A Miles10, Priyank Shah11, Eugene Yuriditsky12, Daryl Jones5,13, Kiran Shekar1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18, Ashwin Subramaniam17,18. 1. Department of Anaesthesia, Austin Hospital, Heidelberg, VIC, Australia. 2. Department of Intensive Care Medicine, Calvary Hospital, Canberra, ACT, Australia. 3. Cambia Palliative Care Centre of Excellence, University of Washington, Seattle, WA. 4. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA. 5. Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. 6. Centre for Integrated Critical Care, Department of Medicine and Radiology, Melbourne Medical School, Melbourne, VIC, Australia. 7. Division of Pulmonary and Critical Care Medicine, Mount Sinai Morningside, New York City, NY. 8. Division of Cardiology, Department of Medicine, University of Michigan, Frankel Cardiovascular Centre, Ann Arbor, MI. 9. Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA. 10. Division of Cardiology, Montefiore Medical Centre, Albert Einstein College of Medicine, Bronx, NY. 11. Department of Cardiology, Phoebe Putney Memorial Hospital, Albany, GA. 12. Division of Cardiology, Department of Medicine, NYU Langone Medical Center, New York City, NY. 13. Department of Intensive Care Medicine, Austin Hospital, Heidelberg, VIC, Australia. 14. Department of Intensive Care Medicine, The Prince Charles Hospital, Brisbane, QLD, Australia. 15. School of Medicine, University of Queensland, Brisbane, QLD, Australia. 16. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia. 17. Department of Intensive Care Medicine, Peninsula Health, Frankston, VIC, Australia. 18. Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.
Abstract
OBJECTIVES: To investigate the incidence, characteristics, and outcomes of in-hospital cardiac arrest in patients with coronavirus disease 2019 and to describe the characteristics and outcomes for patients with in-hospital cardiac arrest within the ICU, compared with non-ICU patients with in-hospital cardiac arrest. Finally, we evaluated outcomes stratified by age. DATA SOURCES: A systematic review of PubMed, EMBASE, and preprint websites was conducted between January 1, 2020, and December 10, 2020. Prospective Register of Systematic Reviews identification: CRD42020203369. STUDY SELECTION: Studies reporting on consecutive in-hospital cardiac arrest with a resuscitation attempt among patients with coronavirus disease 2019. DATA EXTRACTION: Two authors independently performed study selection and data extraction. Study quality was assessed with the Newcastle-Ottawa Scale. Data were synthesized according to the Preferred Reporting Items for Systematic Reviews guidelines. Discrepancies were resolved by consensus or through an independent third reviewer. DATA SYNTHESIS: Eight studies reporting on 847 in-hospital cardiac arrest were included. In-hospital cardiac arrest incidence varied between 1.5% and 5.8% among hospitalized patients and 8.0-11.4% among patients in ICU. In-hospital cardiac arrest occurred more commonly in older male patients. Most initial rhythms were nonshockable (83.9%, [asystole = 36.4% and pulseless electrical activity = 47.6%]). Return of spontaneous circulation occurred in 33.3%, with a 91.7% in-hospital mortality. In-hospital cardiac arrest events in ICU had higher incidence of return of spontaneous circulation (36.6% vs 18.7%; p < 0.001) and relatively lower mortality (88.7% vs 98.1%; p < 0.001) compared with in-hospital cardiac arrest in non-ICU locations. Patients greater than or equal to 60 years old had significantly higher in-hospital mortality than those less than 60 years (93.1% vs 87.9%; p = 0.019). CONCLUSIONS: Approximately, one in 20 patients hospitalized with coronavirus disease 2019 received resuscitation for an in-hospital cardiac arrest. Hospital survival after in-hospital cardiac arrest within the ICU was higher than non-ICU locations and seems comparable with prepandemic survival for nonshockable rhythms. Although the data provide guidance surrounding prognosis after in-hospital cardiac arrest, it should be interpreted cautiously given the paucity of information surrounding treatment limitations and resource constraints during the pandemic. Further research is into actual causative mechanisms is needed.
OBJECTIVES: To investigate the incidence, characteristics, and outcomes of in-hospital cardiac arrest in patients with coronavirus disease 2019 and to describe the characteristics and outcomes for patients with in-hospital cardiac arrest within the ICU, compared with non-ICU patients with in-hospital cardiac arrest. Finally, we evaluated outcomes stratified by age. DATA SOURCES: A systematic review of PubMed, EMBASE, and preprint websites was conducted between January 1, 2020, and December 10, 2020. Prospective Register of Systematic Reviews identification: CRD42020203369. STUDY SELECTION: Studies reporting on consecutive in-hospital cardiac arrest with a resuscitation attempt among patients with coronavirus disease 2019. DATA EXTRACTION: Two authors independently performed study selection and data extraction. Study quality was assessed with the Newcastle-Ottawa Scale. Data were synthesized according to the Preferred Reporting Items for Systematic Reviews guidelines. Discrepancies were resolved by consensus or through an independent third reviewer. DATA SYNTHESIS: Eight studies reporting on 847 in-hospital cardiac arrest were included. In-hospital cardiac arrest incidence varied between 1.5% and 5.8% among hospitalized patients and 8.0-11.4% among patients in ICU. In-hospital cardiac arrest occurred more commonly in older male patients. Most initial rhythms were nonshockable (83.9%, [asystole = 36.4% and pulseless electrical activity = 47.6%]). Return of spontaneous circulation occurred in 33.3%, with a 91.7% in-hospital mortality. In-hospital cardiac arrest events in ICU had higher incidence of return of spontaneous circulation (36.6% vs 18.7%; p < 0.001) and relatively lower mortality (88.7% vs 98.1%; p < 0.001) compared with in-hospital cardiac arrest in non-ICU locations. Patients greater than or equal to 60 years old had significantly higher in-hospital mortality than those less than 60 years (93.1% vs 87.9%; p = 0.019). CONCLUSIONS: Approximately, one in 20 patients hospitalized with coronavirus disease 2019 received resuscitation for an in-hospital cardiac arrest. Hospital survival after in-hospital cardiac arrest within the ICU was higher than non-ICU locations and seems comparable with prepandemic survival for nonshockable rhythms. Although the data provide guidance surrounding prognosis after in-hospital cardiac arrest, it should be interpreted cautiously given the paucity of information surrounding treatment limitations and resource constraints during the pandemic. Further research is into actual causative mechanisms is needed.
Authors: Emily E Moin; Daniel Okin; Sirus J Jesudasen; Nupur A Dandawate; Alexander Gavralidis; Leslie L Chang; Alison S Witkin; Kathryn A Hibbert; Aran Kadar; Patrick L Gordan; Lisa M Bebell; Peggy S Lai; George A Alba Journal: Resusc Plus Date: 2022-03-07
Authors: Julia M Edwards; Jerry P Nolan; Jasmeet Soar; Gary B Smith; Emily Reynolds; Jane Carnall; Kathryn M Rowan; David A Harrison; James C Doidge Journal: Resuscitation Date: 2022-02-10 Impact factor: 6.251