Abstract 244: The Detail of Individual Cardiovascular Disease on Inhospital Cardiopulmonary Arrest; From the Japanese Registry of CPR for Inhospital Cardiac Arrest (J-RCPR)
Background: In-hospital cardiopulmonary arrest (IHCPA) is still a serious problem for cardiologists; recent studies have shown almost one half of all the IHCPA patients are based on cardiovascular diseases. However, the detail of individual cardiovascular disease remains unknown.
Method: A total of 491 consecutive adults with IHCPA were registered in J-RCPR as a multicenter trial. Among them, 222 (45%) patients were hospitalized with the treatment of cardiovascular diseases; acute coronary syndrome (ACS, Group A, n=78), heart failure (HF, Group B, n=56), and arrhythmia (Group C, n=77).
Result: Baseline characteristics of sex, age, and consciousness before IHCPA did not show significant difference in each group. Compared with other groups, Group B showed lower rate of ECG monitoring (Group A: 90%, Group B: 70%, Group C: 95%, p<0.001) and the witnessed IHCPA (95%, 75%, 91%, p<0.001), higher rate of IHCPA in general ward (19%, 63%, 38%. p<0.001). The percentage of IHCPA within 2 days of hospitalization was significantly higher in Group A (61% vs. 39% vs. 43%, p<0.05). Interestingly, the prevalence of first documented rhythm and the first treatment of IHCPA were not different in each group; however, the rate of return of spontaneous circulation (ROSC) is significantly higher in Group C (67%, 55%, 92%, p<0.001) and survival rate after 30days of IHCPA was significantly lower in Group B (41%, 27%, 52%, p<0.001).
Conclusion: ACS patients showed higher rate of IHCPA within 2days of hospitalization; thus, we need to pay special attention to those patients in acute phase of hospitalization. In addition, the fact that patients with HF showed poor prognosis implies ECG monitoring and possible intensive care may lead to better outcome.
- © 2010 by American Heart Association, Inc.