Abstract 243: High Survival Rate of Patients Following In-Hospital Cardiac Arrest in Center Hospital for Cardiac and Cerebrovascular Diseases: A Single-Center Prospective Observational, Utstein Style Study
Background: In-hospital cardiac arrest (IHCA) is a significant public health problem with a low survival rate of approximately 15-20% in general hospitals. However, few data are available on the clinical outcome of patients following IHCA in the center hospital for cardiac and cerebrovascular diseases.
Methods: Between June 2006 and May 2013, Utstein style resuscitation data were prospectively collected on 535 consecutive patients aged 18 years or older who developed IHCA in National Cerebral and Cardiovascular Center (Osaka, Japan). Of these, we excluded 95 patients with multiple cardiac arrests (only the first episode was included) and also excluded 9 patients due to the lack of 30-day follow-up data. We finally assessed the data of the clinical characteristics and 30-day survival of 428 patients.
Results: The number of patients who were hospitalized due to cardiac diseases and cerebrovascular diseases was 293 (68.5%) and 84 (19.6%), respectively. The location of hospital where IHCA developed was intensive care unit in 153 (35.7%), general ward in 157 (36.6%), emergency department in 54 (12.6%) and others in 64 (15%). Importantly, the majority of IHCA (n=379, 88.5%) occurred under the monitoring of electrocardiography. The first documented rhythm was pulseless electrical activity in 215 (50.2%), asystole in 77 (18%), ventricular fibrillation (VF) in 73 (17.1%), and pulseless ventricular tachycardia in 63 (14.7%). In only 4 patients who were not originally monitored, an automated external defibrillator was used following documentation of VF as initial rhythm of IHCA. Overall, the 30-day survival rate was 38%. The presence of electrocardiography monitoring was associated with higher survival rate than the absence of monitoring (39.5% vs. 22.4%, P=0.02). However, the survival rate was not significantly affected by the location of hospital, time (day vs. night), and day of the week (weekday vs. weekend).
Conclusions: The survival rate following IHCA seems to be high in the center hospital for cardiac and cerebrovascular diseases in comparisons with the previous reports from general hospitals. The present finding of over 30% survival indicates the potential impact of electrocardiography monitoring for particular patients with risk for IHCA.
- © 2013 by American Heart Association, Inc.