A retrospective study of in‐hospital cardiac arrest

Fujiwara, Shinsuke; Koike, Tomotaka; Moriyasu, Megumi; Nakagawa, Masashi; Atagi, Kazuaki; Lefor, Alan Kawarai; Fujitani, Shigeki; Ikeda, Takeshi; Takamatsu, Yuka; Hasegawa, Yasuhisa; Suzuki, Satoshi; Komuro, T.; Kawamura, Natsuki; Yamada, Narumi

doi:10.1002/ams2.193

Cited by 9 publications

(8 citation statements)

References 30 publications

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“…Recently, a Japanese study [4] found similar results with approximately 60% of the patients with abnormal vital signs before a cardiac arrest. Over than 60% of the patients transferred to an ICU have potentially life-threatening abnormalities in the 8 hours before their admission [9].…”

supporting

confidence: 52%

“…From then on, the researchers began to evaluate alterations of clinical signs preceding serious adverse events (SAEs) and the treatment before admission to an intensive care unit (ICU) [3][4][5][6][7][8][9][10][11][12]. A high percentage Nowadays, the role of acute hospitals is changing rapidly and the number of critically ill patients with potentially reversible conditions is increasing [13].…”

Section: Introductionmentioning

confidence: 99%

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Rapid Response Systems: how to interpret levels of evidence

Difonzo

2017

CMI

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Clinical management abstractBACKGROUND AND AIM: The Rapid Response System (RRS) has been introduced to prevent cardiac arrest, unplanned admissions to the intensive care unit, and death in hospitalized patients. Despite the constant and widespread presence of this system in worldwide hospitals, it remains debated whether its use improves patient outcomes. The aim of this narrative review is to describe the available evidence supporting the effectiveness of RRSs and to discuss the controversies on the lack of level 1 evidence studies. METHODS: The literature search covers the period from 1 January 2000 to 31 March 2016. RESULTS: Studies with different research designs, observational, quasi-experimental with non-randomized control group and experimental, and aggregate data of meta-analyses indicate a statistically significant reduction of in-hospital cardiac arrests and hospital mortality associated with the deployment of RRSs. CONCLUSIONS: A RRS is a complex intervention in a complex system, such as a hospital. This complexity does not allow considering experimental trials only as the most appropriate methodology to answer at research objectives. Furthermore, the benefits of a RRS depend greatly on its proper use. Accumulating evidence suggests the importance to investigate barriers and facilitators that can affect the integration, within a hospital, of this complex intervention.

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supporting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Rapid Response Systems: how to interpret levels of evidence

Difonzo

2017

CMI

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“…These parameters describe the condition of circulation and neurological function. This is relevant to previous study which states that systolic blood pressure is the most sensitive circulating function parameter to detect the risk of cardiac arrest (Fujiwara et al, 2016). Another abnormality of the patient's physiological status in ED that associated with the IHCA incidence is the level of conciousness (Considine et al, 2016).…”

Section: Resultsmentioning

confidence: 66%

“…Body temperature indicates the condition of thermoregulation, thermo effector and the body's metabolic regulation functions. Abnormalities that occur before IHCA incidence are related to respiratory function, circulatory function, and neurological function (Fujiwara et al, 2016).…”

Section: Resultsmentioning

confidence: 99%

National Early Warning Score Parameters at the Emergency Department as In Hospital Cardiac Arrest Predictors

Maarif

Sardjono

Utami

2020

IJSOC

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In Hospital Cardiac Arrest (IHCA) is fairly common occurrence, although it can be prevented. Physiological status monitoring at Emergency Departement (ED) is crucial for early detection of potential IHCA incidence. National Early Warning Score (NEWS) is a scoring system to assess deterioration of patient's condition, but it is not yet known which parameters that have predictive value for IHCA incidence. Examine NEWS parameters of the patients while at the ED that have predictive value of IHCA incidence. This study was conducted retrospectively on inpatient medical records. The NEWS parameters examined were respiration rate score, oxygen saturation score, body temperature score, systolic blood pressure score, pulse rate score and level of consciousness score. Logistic regression analysis was used to test the predictive ability of NEWS parameters. Total score NEWS proved to be correlated with IHCA incidence (p=0.000; r=0.434). Parameters that have predictive value are systolic blood pressure score (p=0.001; OR=14.730), respiration rate score (p=0.000; OR=14.483) and level of consciousness score (p=0.000; OR=6.920). The NEWS parameter when the patients will be transferred from ED to the wards that have predictive value for IHCA incidence are systolic blood pressure score, respiration rate score and level of consciousness score.

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“…The majority of the evidence on IHCA is derived from these two registries [ 1 ], and the global incidence of IHCA has not been well described [ 9 , 10 ]. In Japan, only two multi-centre studies involving 491 and 228 IHCA patients have been performed [ 11 , 12 ], and there is currently no nationwide prospective registry for IHCA.…”

Section: Introductionmentioning

confidence: 99%

Incidence and outcomes of in-hospital cardiac arrest in Japan 2011–2017: a nationwide inpatient database study

et al. 2022

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Background Although numerous studies have investigated out-of-hospital cardiac arrest, few studies have been conducted on in-hospital cardiac arrest (IHCA). Knowledge of the nationwide epidemiology of IHCA in Japan, with its super-aging society, is important to understand the current situation of IHCA and to establish evidenced-based medicine in the future. The present study aimed to determine the incidence and outcomes of IHCA and their trends in Japan. Methods This observational cohort study was performed using a national administrative inpatient database for more than 1600 acute-care hospitals covering about 50% of all acute-care hospital beds in Japan from April 2011 to March 2018. We defined cardiac arrest patients who received cardiopulmonary resuscitation (chest compression) during hospitalization as IHCA. We excluded out-of-hospital cardiac arrest patients from the source population. The incidence of IHCA per 1000 hospital admissions and survival to discharge rate was reported with trend analyses by calendar year 2011–2017. Results Among 53,871,101 hospitalized patients without out-of-hospital cardiac arrest patients in 1626 hospitals, 2,136,038 (4.0%) had cardiac arrest. Of them, 274,664 (12.9%) received cardiopulmonary resuscitation at least once during hospitalization and were identified as IHCA, and 1,861,374 (87.1%) did not receive cardiopulmonary resuscitation. The incidence of IHCA per 1000 hospital admissions was 5.1, with a significant decreasing trend from 6.1 in 2011 to 4.6 in 2017 (P for trend = 0.033). Our estimated incidence can be translated to approximately 87,000 IHCA cases in Japan each year. The percentage of IHCA patients among cardiac arrest patients was 12.9%, with a significant decreasing trend from 14.0% in 2011 to 12.2% in 2017 (P for trend = 0.006). The overall rate of survival to discharge was 12.7%, with a significant increasing trend from 10.5% in 2011 to 14.0% in 2017 (P for trend < 0.001). Conclusions We found substantial associations between mortality and loss of health and IHCA in Japan. The incidence of IHCA showed a decreasing trend over time, the percentage of treated cardiac arrest patients also had a decreasing trend, and the overall survival to discharge rate improved over time.

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A retrospective study of in‐hospital cardiac arrest

Cited by 9 publications

References 30 publications

Rapid Response Systems: how to interpret levels of evidence

Rapid Response Systems: how to interpret levels of evidence

National Early Warning Score Parameters at the Emergency Department as In Hospital Cardiac Arrest Predictors

Incidence and outcomes of in-hospital cardiac arrest in Japan 2011–2017: a nationwide inpatient database study

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