Causes of in-hospital cardiac arrest and influence on outcome.
Resuscitation. 2012 May 14;
Authors: Wallmuller C, Meron G, Kurkciyan I, Schober A, Stratil P, Sterz F
AIM OF THE STUDY: To evaluate the relationship between cause and outcome of in-hospital cardiac arrest. METHODS: Retrospective analysis of resuscitation data, causes of cardiac arrest and outcome with a follow-up to 6 months of a cardiac arrest registry in an emergency department of a tertiary care hospital, covering a 17.5-year period. RESULTS: Of 1041 patients, 653 were male (63%), the median age was 64 years (IQR 53 -73), 51% suffered cardiac arrest in the emergency department. The ?rst recorded rhythm showed PEA in 432 (41%), ventricular ?brillation in 404 (39%) and asystole in 205 (20%) patients. Cardiac arrest of cardiac origin occurred in 63% of all patients, with 35% of them due to acute myocardial infarction. Non-cardiac causes were mostly due to pulmonary causes (15% of all patients). Aortic dissection/rupture, exsanguination, intoxication and adverse drug reactions, metabolic, cerebral, sepsis and accidental hypothermia each ranged between 1 and 4% of the cohort. Of all patients, 376 (36%) were discharged in good neurologic condition. Overall, patients with cardiac causes had a significantly better outcome than those with non-cardiac causes (44 vs. 23%, p<0.01). Patients with pulmonary causes survived in 24%. The other subgroups showed widely divergent survival results (3 to 65%). Patients who had suffered cardiac arrest in the emergency department had a better outcome then patients of the regular ward or radiology department. CONCLUSION: In hospital cardiac arrest is caused mainly by cardiac and pulmonary causes, outcome depends on the cause, with a big variability.
PMID: 22595441 [PubMed – as supplied by publisher]