Association Between Time to Defibrillation and Neurologic Outcome in Patients With In-Hospital Cardiac Arrest

Kang, Jin-Young; Kim, Youn-Jung; Shin, Yu Jung; Huh, Jin Won; Hong, Sang-Bum; Kim, Won Young

doi:10.1016/j.amjms.2019.05.003

Cited by 17 publications

(12 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent observational retrospective study conducted by Chang et al, ED crowding was roughly associated with IHCA occurrence. 24 In this study, ED bed occupancy rate (EDBOR) was used as an overcrowding index by calculating the ratio of the total number of filled beds divided by the total number of licensed ED beds. However, EDBOR is an index that has never been used before and it is difficult to compare with other studies.…”

Section: Discussionmentioning

confidence: 99%

Maximum emergency department overcrowding is correlated with occurrence of unexpected cardiac arrest

Kim

Bae²,

Sohn

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background Emergency department overcrowding negatively impacts critically ill patients and could lead to the occurrence of cardiac arrest. However, associations between emergency department crowding and occurrence of both in-hospital cardiac arrest and out-of-hospital cardiac arrest have not been thoroughly investigated. This study aimed to evaluate the correlation between emergency department occupancy rates and incidence of in-hospital and out-of-hospital cardiac arrest. Methods A single-center, observational, registry-based cohort study was performed including all consecutive adult, non-traumatic cardiac arrest patients between January 2014 and June 2017. We used emergency department occupancy rates as a crowding index at time of presentation time of cardiac arrest and at the time of maximum crowding, and the average crowding rate for the duration of emergency department stay for each patient. To calculate incidence rate, we divided the number of arrest cases for each emergency department occupancy period by accumulated time. The primary outcome is association between the incidence of in-hospital cardiac arrest and out-of-hospital cardiac arrest and emergency department occupancy rates. Results During the study period, 629 adult, non-traumatic cardiac arrest patients were enrolled in our registry. Among these, 187 patients experienced in-hospital cardiac arrest and 442 patients had out-of-hospital cardiac arrest. In-hospital cardiac arrest patients compared to out-of-hospital cardiac arrest patients had a significantly higher return of spontaneous circulation rates (16.5% vs. 4.8%; P < .01) and better neurologic outcomes at discharge (cerebral performance category scales 4.7 vs. 4.0; P < .01). Emergency department occupancy rates were positively correlated with in-hospital cardiac arrest occurrence. Moreover, maximum emergency department occupancy in the critical zone had the strongest positive correlation with in-hospital cardiac arrest occurrence (Spearman rank correlation ρ = 1.0, P < .01). Out-of-hospital cardiac arrest incidence was negatively correlated with emergency department occupancy (ρ = -0.79, P = .04). Conclusion Maximum emergency department occupancy was strongly associated with in-hospital cardiac arrest occurrence, while occupancy rate was negatively correlated with out-of-hospital cardiac arrest incidence.

show abstract

Section: Discussionmentioning

confidence: 99%

Maximum emergency department overcrowding is correlated with occurrence of unexpected cardiac arrest

Kim

Bae²,

Sohn

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…For successful resuscitation of patients with IHCA, an appropriate survival environment that includes operation of an RRT, training in ALS, establishment of a cardiac arrest treatment system, and quality improvement activities must be established. [129][130][131] An RRT is designed to detect patients who are deteriorating rapidly at an early stage and to respond appropriately. 13 The role of an RRT includes making decisions about transferring the patient to the intensive care unit, implementing a do-not-resuscitate order, performing intensive care including CPR, and planning care for a patient with terminal illness.…”

Section: Rrt and Early Warning Score In Ihcamentioning

confidence: 99%

2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 4. Adult advanced life support

Cha

Lee

et al. 2021

Clin Exp Emerg Med

View full text Add to dashboard Cite

Adult advanced life support (ALS) is an important part of the chain of survival, promoting systemic circulation and oxygen supply during high-quality basic life support in patients with cardiac arrest. It includes advanced airway management, manual defibrillation, pharmacological therapy with vasopressors and antiarrhythmic agents, use of an extracorporeal circulation device, and other techniques to achieve return of spontaneous circulation (ROSC). [1][2][3] Several milestone studies on ALS have been published since the publication of the 2015 Korean cardiopulmonary resuscitation (CPR) guidelines. These include a multicenter, randomized, double-blind, placebo-controlled study evaluating the effect of epinephrine in patients with out-ofhospital cardiac arrest (OHCA) as well as a comparative study on amiodarone, lidocaine, or placebo in patients with refractory shockable rhythm. 4,5 A study comparing the use of a supraglottic airway (SGA) device and endotracheal intubation for advanced airway management during OHCA S27

show abstract

“…C ardiac arrest (CA) is a global public health problem with an estimated crude incidence of 55 cases of out-ofhospital CA per 100,000 person-years and 10 cases of inhospital CA per 1000 hospital admissions (Berdowski et al, 2010;Andersen et al, 2019). While there have been major advances in prevention and resuscitation strategies, morbidity and mortality rates remain unacceptably high (Kong et al, 2011;Kim et al, 2016;Kang et al, 2019). This is largely due to postcardiac arrest syndrome (PCAS), which comprises postarrest brain injury, postarrest myocardial dysfunction, and systemic ischemia-reperfusion injury (Nolan et al, 2008;Stub et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Severity of Acute Respiratory Distress Syndrome Following Cardiac Arrest on Neurologic Outcomes

Kim

et al. 2021

Therapeutic Hypothermia and Temperature Management

Self Cite

View full text Add to dashboard Cite

The aim of this study was to evaluate the incidence and determinants of acute respiratory distress syndrome (ARDS) after cardiac arrest (CA). We conducted an observational, retrospective cohort study with consecutive adult out-of-hospital and in-hospital (occurred only in the emergency department, ED) CA survivors from our ED. Development of ARDS was identified by results of arterial blood gases, chest images, and transthoracic echocardiography according to the Berlin definition. The primary outcome was the poor neurologic outcome, defined as cerebral performance category q3 at 28 days, and secondary outcomes were 28-day mortality, recovery rate from ARDS, duration of mechanical ventilator use, and length of stay. Among 295 enrolled patients, 30 patients who received extracorporeal membrane oxygenation and 19 patents who had cardiogenic pulmonary edema were excluded. ARDS had developed in 119 ( 48.4%) patients on admission (mild 20 [16.8%], moderate 48 [40.3%], and severe 51 [42.9%]) and 54 (45.4%) patients recovered before hospital discharge. Development of ARDS was associated with poor neurologic outcomes at 28 days (adjusted hazard ratio (HR) 1.44 [95% confidence interval (CI): 1.05-1.98]). Moreover, more severe ARDS was associated with a higher risk of poor neurological outcomes (mild: reference; moderate: adjusted HR 1.66 [95% CI: 1.10-2.49]; and severe: adjusted HR 1.76 [95% CI: 1.16-2.65]). Therefore, development of ARDS after CA was associated with unfavorable neurologic outcomes and had a linear association with ARDS severity. Early recognition and proper management of ARDS may be useful during post-CA care.

show abstract

Association Between Time to Defibrillation and Neurologic Outcome in Patients With In-Hospital Cardiac Arrest

Cited by 17 publications

References 16 publications

Maximum emergency department overcrowding is correlated with occurrence of unexpected cardiac arrest

Maximum emergency department overcrowding is correlated with occurrence of unexpected cardiac arrest

2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 4. Adult advanced life support

The Impact of Severity of Acute Respiratory Distress Syndrome Following Cardiac Arrest on Neurologic Outcomes

Contact Info

Product

Resources

About