Abstract 171: Cardiac Arrest Outcomes Data Evaluation---CODE Registry: Brazilian Registry of In-Hospital Cardiopulmonary Resuscitation
INTRODUCTION: In spite of the advances and worldwide standardization for cardiopulmonary resuscitation (CPR), knowledge on the effectiveness of in-hospital CPR is not yet sufficient in Brazil.
Methods: This cross-sectional study included, prospectively, 763 patients who presented in-hospital cardiac arrest (CA) from 2007 to 2010, in 17 hospitals. CPR was performed in 575 patients.
RESULTS: Asystole was the CA modality most frequently found (40.7%), followed by pulseless electrical activity (39,3%). Immediate survival (recovery of spontaneous circulation - ROSC up to 24 h) was 48,8%, survival until hospital discharge was 13%, 4.3% in 6 m and 3.8% in 12 months. Independent predictors associated with higher immediate survival were: ventricular fibrillation (VF) or ventricular tachycardia (VT) without pulse as the initial rhythm of CA (RR 1.31; IC 95% 1.10 to 1.55; p = 0.002); presence of victim consciousness signs when the emergency staff arrived (RR 1.37; IC95% 1.16 to 1.61; p < 0.001); use of epinephrine (RR 1.61; IC 95% 1.32 to 1.98; p < 0.001); hypoglycemia as cause of CA (RR 1.68; IC 95% 1.11 to 2.55; p = 0.014). Independent predictors associated with lower immediate survival were: hypotension as cause of CA (RR 0.74; IC 95% 0.61 to 0.90; p = 0.003); sedentary lifestyle (RR 0.76; IC 95% 0.66 to 0.88; p < 0.001) and duration of the CPR. Independent predictors associated with hospital discharge survival were: the emergency team trained in ACLS and/or BLS (HR 3.07; IC 95% 1.39 to 6.78; p = 0.006), sinus rhythm after ROSC (HR 1.44; IC 95% 1.26 to 1.75; p = 0.002). Independent predictors of higher 6-month survival rate were: use of epinephrine, sinus rhythm after ROSC and previous MI. Independent predictors of 12-month survival were not identified.
CONCLUSION: As independent predictors for immediate survival we identified: VF or VT without pulse as the initial rhythm, presence of signs of awareness of the victim, use of epinephrine, hypoglycemia as cause of PCR. As independent predictors associated survival until discharged: training in ACLS/BLS and the sinus rhythm after ROSC. These findings suggest a national resuscitation profile, providing relevant information, potentially representative of the in-hospital CPR in Brazil.
- © 2011 by American Heart Association, Inc.