Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports: Update of the Utstein Resuscitation Registry Template for In-Hospital Cardiac Arrest

Nolan, Jerry P.; Berg, Robert A.; Andersen, Lars W.; Bhanji, Farhan; Chan, Paul S.; Donnino, Michael W.; Lim, Swee Han; Huei‐Ming, Matthew; Nadkarni, Vinay; Starks, Monique Anderson; Perkins, Gavin D; Morley, Peter; Soar, Jasmeet; Aickin, Richard; Atkins, Dianne L.; Berg, Katherine M.; Bingham, Robert; Böttiger, Bernd W.; Brooks, Steven C.; Callaway, Clifton W.; Castrèn, Maaret; Chung, Sung Phil; Considine, Julie; Couto, Thomaz Bittencourt; Caen, Allan R. de; Deakin, Charles D.; Drennan, Ian R.; Escalante, Raffo; Gazmuri, Raúl J; Guerguerian, Anne‐Marie; Hazinski, Mary Fran; Kudenchuk, Peter J.; Løfgren, Bo; Maconochie, Ian; Mancini, Mary E.; Meaney, Peter A; Neumar, Robert W.; Ng, Kee-Chong; Nicholson, Tonia; Nishiyama, Chika; Nuthall, Gabrielle; Olasveengen, Theresa M.; Paiva, Edison Ferreira de; Parr, Michael J.; Reis, Amélia G.; Reynolds, Joshua C.; Ristagno, Giuseppe; Sandroni, Claudio; Schexnayder, Stephen M.; Scholefield, Barnaby R; Smyth, Michael A.; Stanton, David; Tijssen, Janice A.; Vaillancourt, Christian; Voorde, Patrick Van de; Wang, Tzong-Luen; Welsford, Michelle

doi:10.1016/j.resuscitation.2019.08.021

Cited by 106 publications

(69 citation statements)

References 47 publications

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“…It was conducted in three large university affiliated tertiary hospitals in two countries with different healthcare contexts and data were collected using the recently updated Utstein template for IHCA. 6 Both factors enhance the external validity of our results. The study is limited by its observational design allowing for associations to be discussed but without any inference of causality.…”

Section: Study Limitationsmentioning

confidence: 58%

“…The International Liaison Committee on Resuscitation (ILCOR) published new Utstein Guidelines for IHCA on November 2019 underlining the precise recording of core and supplemental data elements. 6 While the acuity and morbidity of hospitalized patients have increased substantially as a result of expanding treatment possibilities in recent decades, the incidence of IHCA seems to have remained stable or even declined. 3,7 The international adaptation of rapid response systems (RRSs) into hospitals' standard operating procedures may in part explain this trend.…”

Section: Introductionmentioning

confidence: 99%

“…RRSs, but only one previous study has investigated the interface between RRS factors and subsequent IHCAs by cross-linking hospital registries in the United States in 2000-2014 suggesting missed intervention opportunities in many RRS hospitals. 9 In this multicentre study from two Finnish and one Australian university-affiliated tertiary hospitals with mature RRSs we aimed 1) to describe in detail the core and supplemental data of in-hospital cardiac arrest as suggested in ILCOR statement, 6 2) to document RRS factors preceding the cardiac arrests and 3) to investigate the factors independently associated with a favourable neurological outcome at hospital discharge.…”

Section: Introductionmentioning

confidence: 99%

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In-hospital cardiac arrest in hospitals with mature rapid response systems — a multicentre, retrospective cohort study

et al. 2020

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Aim: To investigate in-hospital cardiac arrests (IHCAs) according to the Ustein template in hospitals with mature systems utilizing rapid response teams (RRTs), with a special reference to preceding RRT factors and factors associated with a favourable neurological outcome (cerebral performance category (CPC) 1-2) at hospital discharge. Methods: Multicentre, retrospective cohort study between 2017-2018 including two Finnish and one Australian university affiliated tertiary hospitals. Results: A total 309 IHCAs occurred with an incidence of 0.78 arrests per 1,000 hospital admissions. The median age of the patients was 72 years, 63% were male and 73% had previously lived a fully independent life with a median Charlson comorbidity index of two. Before the IHCA, 16% of the patients had been reviewed by RRTs and 26% of the patients fulfilled RRT activation criteria in the preceding 8 hours of the IHCA. Return of spontaneous circulation was achieved in 53% of the patients and 28% were discharged from hospital with CPC 1-2. In a multivariable model, younger age, no pre-arrest RRT criteria, arrest in normal work hours, witnessed arrest and shockable initial rhythm were independently associated with CPC 1-2 at hospital discharge. Conclusions: In hospitals with mature rapid response systems most IHCA patients live a fully independent life with low burden of comorbid diseases before their hospital admission, the IHCA incidence is low and outcome better than traditionally believed. Deterioration before IHCA is present in a significant number of patients and improved monitoring and earlier interventions may further improve outcomes.

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Section: Study Limitationsmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In-hospital cardiac arrest in hospitals with mature rapid response systems — a multicentre, retrospective cohort study

et al. 2020

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“…Cardiopulmonary resuscitation and post-CA care were performed in accordance with the European Resuscitation Council guidelines [25]. Data were collected according to Utstein-style guidelines [26]. Cardiac failure was defined as the need for inotrope/vasopressors (dobutamine, epi−/norepinephrine) during the first 72 h after CA [27].…”

Section: Study Definitions and Patient Managementmentioning

confidence: 99%

Effects of COVID-19 on in-hospital cardiac arrest: incidence, causes, and outcome – a retrospective cohort study

Roedl

Söffker

Fischer

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), an emerging virus, has caused a global pandemic. Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has led to high hospitalization rates worldwide. Little is known about the occurrence of in-hospital cardiac arrest (IHCA) and high mortality rates have been proposed. The aim of this study was to investigate the incidence, characteristics and outcome of IHCA during the pandemic in comparison to an earlier period. Methods This was a retrospective analysis of data prospectively recorded during 3-month-periods 2019 and 2020 at the University Medical Centre Hamburg-Eppendorf (Germany). All consecutive adult patients with IHCA were included. Clinical parameters, neurological outcomes and organ failure/support were assessed. Results During the study period hospital admissions declined from 18,262 (2019) to 13,994 (2020) (− 23%). The IHCA incidence increased from 4.6 (2019: 84 IHCA cases) to 6.6 (2020: 93 IHCA cases)/1000 hospital admissions. Median stay before IHCA was 4 (1–9) days. Demographic characteristics were comparable in both periods. IHCA location shifted towards the ICU (56% vs 37%, p < 0.01); shockable rhythm (VT/VF) (18% vs 29%, p = 0.05) and defibrillation were more frequent in the pandemic period (20% vs 35%, p < 0.05). Resuscitation times, rates of ROSC and post-CA characteristics were comparable in both periods. The severity of illness (SAPS II/SOFA), frequency of mechanical ventilation and frequency of vasopressor therapy after IHCA were higher during the 2020 period. Overall, 43 patients (12 with & 31 without COVID-19), presented with respiratory failure at the time of IHCA. The Horowitz index and resuscitation time were significantly lower in patients with COVID-19 (each p < 0.01). Favourable outcomes were observed in 42 and 10% of patients with and without COVID-19-related respiratory failure, respectively. Conclusion Hospital admissions declined during the pandemic, but a higher incidence of IHCA was observed. IHCA in patients with COVID-19 was a common finding. Compared to patients with non-COVID-19-related respiratory failure, the outcome was improved.

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“…ROSC was defined as the documented return of adequate circulation in the absence of ongoing chest compressions for at least 20 consecutive minutes (return of adequate pulse/heart rate by palpation, auscultation, Doppler, arterial blood pressure waveform, or documented blood pressure >50 mmHg systolic) achieved during the event. 12 Any ROSC was considered as a positive outcome and the initial ROSC following cardiopulmonary resuscitation after IHCA was demonstrated without any reference to the neurological outcome or hospital discharge. We decided to set ROSC as an endpoint because we wanted to focus on the immediate result of resuscitation.…”

Section: Data Collectionmentioning

confidence: 99%

Healthcare professionals’ knowledge on cardiopulmonary resuscitation correlated with return of spontaneous circulation rates after in-hospital cardiac arrests: A multicentric study between university hospitals in 12 European countries

Kourek

Greif

Georgiopoulos

et al. 2020

European Journal of Cardiovascular Nursing

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Background: In-hospital cardiac arrest is a major cause of death in European countries, and survival of patients remains low ranging from 20% to 25%. Aims: The purpose of this study was to assess healthcare professionals’ knowledge on cardiopulmonary resuscitation among university hospitals in 12 European countries and correlate it with the return of spontaneous circulation rates of their patients after in-hospital cardiac arrest. Methods and results: A total of 570 healthcare professionals from cardiology, anaesthesiology and intensive care medicine departments of European university hospitals in Italy, Poland, Hungary, Belgium, Spain, Slovakia, Germany, Finland, The Netherlands, Switzerland, France and Greece completed a questionnaire. The questionnaire consisted of 12 questions based on epidemiology data and cardiopulmonary resuscitation training and 26 multiple choice questions on cardiopulmonary resuscitation knowledge. Hospitals in Switzerland scored highest on basic life support ( P=0.005) while Belgium hospitals scored highest on advanced life support ( P<0.001) and total score in cardiopulmonary resuscitation knowledge ( P=0.01). The Swiss hospitals scored highest in cardiopulmonary resuscitation training ( P<0.001). Correlation between cardiopulmonary resuscitation knowledge and return of spontaneous circulation rates of patients with in-hospital cardiac arrest demonstrated that each additional correct answer on the advanced life support score results in a further increase in return of spontaneous circulation rates (odds ratio 3.94; 95% confidence interval 2.78 to 5.57; P<0.001). Conclusion: Differences in knowledge about resuscitation and course attendance were found between university hospitals in 12 European countries. Education in cardiopulmonary resuscitation is considered to be vital for patients’ return of spontaneous circulation rates after in-hospital cardiac arrest. A higher level of knowledge in advanced life support results in higher return of spontaneous circulation rates.

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Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports: Update of the Utstein Resuscitation Registry Template for In-Hospital Cardiac Arrest

Cited by 106 publications

References 47 publications

In-hospital cardiac arrest in hospitals with mature rapid response systems — a multicentre, retrospective cohort study

In-hospital cardiac arrest in hospitals with mature rapid response systems — a multicentre, retrospective cohort study

Effects of COVID-19 on in-hospital cardiac arrest: incidence, causes, and outcome – a retrospective cohort study

Healthcare professionals’ knowledge on cardiopulmonary resuscitation correlated with return of spontaneous circulation rates after in-hospital cardiac arrests: A multicentric study between university hospitals in 12 European countries

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