Abstract 237: Favorable Prognosis in Cardiovascular Disease from In-Hospital Cardiac Arrest Developed Within 48 Hours of Hospital Admission: From the Japanese Registry of CPR for In-Hospital Cardiac Arrest (J-RCPR)
Background: Recently, importance of in-hospital cardiopulmonary arrest (IHCPA) is recognized. Some studies showed the characteristics of IHCPA, however, the detail of IHCPA developed within 48-hours of hospital admission remains unknown.
Method: A total of 491 adults with IHCPA were registered in J-RCPR from January 2008 to December 2009 as a multicenter prospective registry study. Among them, 182 IHCPA developed within 48-hours of hospital admission were retrospectively reviewed. They were divided in two groups according to the underlying disease, hospitalized for the treatment of cardiovascular disease (Group C, n=116, including ACS / Arrhythmia / Heart failure / Aortic diseases), and non- cardiovascular disease (Group N, n=66).
Result: Baseline characteristics of sex, age, and pre-event consciousness were not statistically different in each group. The location of IHCA was significantly different, the prevalence of IHCPA in intensive care unit (ICU) and catheter laboratory were significantly higher in Group C (p<0.01). The percentages of patients with ECG monitor and developed IHCPA within 10 min of the last checking time were significantly higher in Group C than Group N (90.4% vs. 75.5%, 87.1% vs. 74.2%, p<0.05 respectively). In Group C (Group N), the prevalence of VF/VT as first documented rhythm was 37.8% (19.7%, p<0.0001), asystole was 16.5% (36.3%, p<0.0001), and pulseless electrical activity was 35.7% (44.0%, N.S.). Interestingly, in Group C, the rate of survival at 30 days after IHCPA was significantly higher than Group N (43.1% vs. 22.9%, p<0.001), even though the rate of return of spontaneous circulation and of survival at 24-hours 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 (86.0% vs. 63.6%, p<0.05).
Conclusion: Patients in Group C showed better survival than non-cardiovascular disease in this study; 37% of patients with cardiovascular disease developed IHCPA within 48-hours of hospital admission could recover without neurological deficiency. These results suggest the importance of careful observation of the patients in the first few days of hospital admission.
- © 2011 by American Heart Association, Inc.