Abstract 36: Etiology of In-Hospital Cardiopulmonary Arrest as a Predictor of Outcome
Background: Inpatient cardiopulmonary arrest (CPA) is poorly defined. However, understanding the factors contributing to incidence and outcome is critical in designing effecting CQI programs.
Objective: To explore the effectiveness of an arrest taxonomy, using specific etiologies of inpatient CPA, to predict incidence and outcomes and direct CQI efforts.
Methods: This study was conducted in two urban university hospitals from 2005-09. The Advanced Resuscitation Training (ART) program was implemented in 2007. Clinical and demographic data were abstracted from the institutional resuscitation database. Broad categories regarding arrest etiology [sepsis, hemorrhage, pulmonary embolus, VF/VT, vagal, neurologic, heart failure, intubated respiratory, and non-intubated respiratory] were incorporated into a multivariate logistic regression model using survival-to-hospital discharge as the primary outcome. In addition, chi-square analysis of incidence and graphical analysis of incidence and survival trends for specific etiologies before and after ART implementation were performed.
Results: A total of 332 inpatients suffered CPA during the study period [pre-ART n=182, post-ART n=150]. Multivariate logistic regression revealed an independent association with outcome for each of the etiologies but not for other covariates. A decrease in the incidence and improvement in survival for certain arrest etiologies was observed following ART implementation.
Conclusion: We observed important associations between arrest etiology and both incidence and outcome from inpatient CPA. This taxonomy may be helpful in guiding CQI efforts.
- © 2012 by American Heart Association, Inc.