Abstract 14350: The Importance of ECG Monitoring of Patients with Heart Failure: From the Japanese Registry of CPR for In-hospital Cardiac Arrest (J-RCPR)
Background: In-hospital cardiopulmonary arrest (IHCPA) is an important matter; recent studies have shown almost one half of all the IHCPA patients are based on cardiovascular diseases. However, the details of in-hospital cardiopulmonary arrest in heart failure patients remain unknown. To evaluate the impact of heart failure in IHCPA patients, we retrospectively reviewed the database of J-RCPR.
Method: A total of 491 consecutive adults with IHCPA were registered in J-RCPR as a multicenter trial. Among them, 222 (45.2%) patients were hospitalized with the treatment of cardiovascular diseases. They divided in two groups according to the underlying disease, hospitalized for the treatment of HF (Group HF, n=56), and other cardiovascular diseases Group OT, n=166, ACS 78, Arrhythmia 77, others 11).
Result: Baseline characteristics of sex, age, and consciousness before IHCPA did not show significant difference in the groups. Group HF showed lower rate of ECG monitoring (67.9% vs. 89.2%, p<0.005) and the witnessed IHCPA (73.2% vs. 92.8%, p<0.005), higher rate of occurrence of IHCPA in general ward (62.5% vs. 28.3%. p<0.001). The percentage of IHCPA after 2 days of hospitalization was significantly higher in Group HF 60.7% vs. 47.6%, p<0.05). Interestingly, the prevalence of first documented rhythm of IHCPA was not different, however, the rate of return of spontaneous circulation (ROSC) and the survival rate after 30 days of IHCPA is significantly lower in Group HF (55.4% vs. 79.5%, p<0.001, 26.8% vs. 46.4%, p<0.005, respectively).
Conclusion: HF patients showed higher rate of IHCPA after 2days of hospitalization. In addition, we found the difference in outcome after IHCPA; HF patients showed poorer prognosis compared with other cardiovascular diseases even though the prevalence of first documented rhythm was not different. Those findings suggest the importance of ECG monitoring of patients with heart failure in general ward.
- © 2012 by American Heart Association, Inc.