Abstract 16789: Impact of Underlying Diseases on the Prognosis in Patients with Inhospital Cardiac Arrest; from the Japanese Registry of CPR for Inhospital Cardiac Arrest (J-RCPR)
Background: In-hospital cardiopulmonary arrest (IHCPA) is an important factor of all cause of death. Although National Registry of Cardio Pulmonary Resuscitation (NRCPR) from United States has reported the rate of discharge was 18%, the impact of underlying disease on IHCPA remains unknown.
Method: A total of 491 consecutive adults with IHCPA were registered in J-RCPR as a multicenter trial. They were divided into two groups according to the underlying diseases; cardiovascular disease (Group C, n=265, including ACS/Arrhythmia/Heart failure/Aortic diseases), and non-cardiovascular disease (Group N, n=226).
Result: Baseline characteristics of sex, age did not show significant difference in Group C and Group N. In group C (Group N), the prevalence of Vf/VT as first documented rhythm was 38.5% (16.4%, p<0.0001), asystole was 20.8% (39.8%, p<0.0001), and pulseless electrical activity was 39.6% (41.2%, N.S.). The prevalence of witnessed IHCPA was significantly higher in Group C than Group N (85.7% vs. 66.4%, p<0.0001). The percentage of IHCA within 2 days of hospitalization was significantly higher in Group C (46.0% vs. 30.1%, p<0.001). The place and the direct cause of IHCPA were different in each group. In group C, the rate of survival on 24 hours and 30 days after IHCPA was significantly higher than Group N (57.0%, 36.6% vs. 42.5%, 18.6%, p<0.001 respectively.), even though the rate of return of spontaneous circulation (ROSC) was not significantly different. The rate of the favorable neurological function (CPC 1–2) among patients survived at 30 days after IHCPA was also higher in Group C (82.4% vs. 45.9%, p<0.001).
Conclusion: Group C showed higher incidence of IHCPA in the early period of hospitalization and VT/Vf as first documented rhythm. Also, they showed better survival and neurological outcome from IHCPA. These results suggest the importance of intensive care in the early period of hospitalization in patients with cardiovascular disease.
- © 2010 by American Heart Association, Inc.