Characteristics and outcome among patients suffering in-hospital cardiac arrest in monitored and non-monitored areas

Herlitz, Johan; Bång, Angela; Aune, Solveig; Ekström, Lars; Lundström, G; Holmberg, Stig

doi:10.1016/s0300-9572(00)00249-5

Cited by 120 publications

(62 citation statements)

References 18 publications

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“…17 Although our study identified age as a significant variable for survival to discharge it is considered a controversial prognostic factor. 18 Similar to our study previous research has shown that patients who arrest at night time have worse outcomes 20,23,24 and this is thought to be multi-factorial including differences in patients as well as health care staff, hospital staffing and operational factors. 24 We found a significant difference between initial rhythms for day and night time arrests with night time arrests having a higher number of initial non-shockable rhythms documented reflecting findings from other studies.…”

Section: After Implementation Of the Arc 2006 Guidelines Our Results supporting

confidence: 85%

In-hospital cardiac arrests: effect of amended Australian Resuscitation Council 2006 guidelines

Boyde¹,

Padget²,

Burmeister³

et al. 2013

Aust. Health Review

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This is the accepted version of the paper.This version of the publication may differ from the final published version. Permanent repository link What is known about this topic?The evaluation of outcomes from in-hospital cardiac arrests focuses on immediate survival expressed as ROSC and survival to hospital discharge. These clinical outcomes have not improved substantially over the last two decades. What does this paper add?This paper identifies the factors that are related to ROSC and survival to discharge following the implementation of the ARC 2006 guidelines which included a refocus on providing quality CPR with minimal interruptions. What are the implications for practitioners?Given that multiple factors can influence clinical outcomes following an in-hospital cardiac arrest, focusing on maximising a range of factors surrounding CPR is essential to improve outcomes.

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Section: After Implementation Of the Arc 2006 Guidelines Our Results supporting

confidence: 85%

In-hospital cardiac arrests: effect of amended Australian Resuscitation Council 2006 guidelines

Boyde¹,

Padget²,

Burmeister³

et al. 2013

Aust. Health Review

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“…Wydaje się, że na decyzję o podjęciu/odstąpieniu od resuscytacji może rzutować brak uregulowań prawnych pozwalających na zastosowanie procedury DNR. Zmiana tego stanu rzeczy mogłaby wpłynąć na zmniejszenie częstości bezskutecznego podejmowania resuscytacji u pacjentów w stanie terminalnym [12,13].…”

Section: Dyskusjaunclassified

“…Wczesna identyfikacja stanu zagrożenia życia, czemu służy między innymi system wczesnego ostrzegania (EWS, early warning system), pozwala według niektórych źródeł na zmniejszenie częstości występowania wewnątrzszpitalnego NZK [17]. Możliwie wczesna ocena stanu klinicznego pacjenta pod kątem rokowania pozwala jednak na uniknięcie resuscytacji daremnej [13].…”

Section: Dyskusjaunclassified

Ocena częstości występowania wewnątrzszpitalnego nagłego zatrzymania krążenia w Polsce

Adamski¹,

Nowakowski²,

Goryński³

et al. 2016

Anaesthesiol Intensive Ther

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Background: In-hospital cardiac arrest with its poor prognosis is a challenging problem in hospitals. The aim of this study was to evaluate in Polish hospitals the frequency of in-hospital cardiac arrests with the subsequent mortality, with special emphasis on the type of unit at which the event occurred, and the patient's demographic data, such as age and sex. Methods: The study was a retrospective analysis of data for 2012 registered in the Polish General Hospital Morbidity Study. This research covered all Polish hospitals, excluding only government and psychiatric hospitals. The study inclusion criterion was the incidence of cardiac arrest in any hospital ward, recorded by the respective ICD-10 diagnosis code. Results: Of the 7,775,553 patients hospitalized, the diagnosis of cardiac arrest was reported in a total of 22,602 patients, which included 22,317 adults (98.7% of all patients) and 285 children (1.3%). Overall mortality after cardiac arrest among adults was 74.2%, and in children 46.7%. In both absolute numbers and as percentages of all documented cases, cardiac arrests occurred most often at the departments of intensive care, internal medicine, cardiology and emergency medicine. The accompanying mortal ity was lower than average at the departments of intensive care, cardiology, cardiology high dependency unit and emergency medicine. The median age of patients with cardiac arrest who died in the hospital was higher than the median age of those who survived (72 vs. 64; P < 0.05). Although cardiac arrests were reported more often among men than women (58.2% vs. 41.8%; P < 0.001), the hospital mortality was higher among women (79.2% vs. 71.6%; P < 0.001). Conclusion:The frequency of in-hospital cardiac arrests in Polish hospitals and the subsequent mortality is not substantially different from that observed in other countries. However, our study, based on ICD-10 diagnosis codes, gives only limited information about the patients and circumstances of this event. An in-depth analysis of the causes, prognoses, and outcome of in-hospital cardiac arrests could be facilitated by the creation of a national registry.

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“…Also, the response to IHCA in general wards is expected to be less efficient than in the ICU because of delayed diagnosis, poor monitoring, and the lack of equipment and well trained staff. 3,[12][13][14] A paper by Brady et al reported that patients who have witnessed and/or monitored cardiac arrest have a significantly higher rate of survival to hospital discharge than patients whose cardiac arrest is neither monitored nor witnessed. 15 We hypothesized that survival to hospital discharge after IHCA would be significantly different for patients in general wards than those in ICUs.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes of Witnessed and Monitored Cases of In-Hospital Cardiac Arrest in the General Ward of a University Hospital in Korea

et al. 2013

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The main outcomes included survival to hospital discharge, incidence of IHCA, and prognostic factors related to hospital mortality. We also investigated preventable cases. RESULTS: We identified 238 index cases of IHCA. The average incidence of IHCA was 0.145 IHCAs per 1,000 patient admissions. Survival to hospital discharge was 19% (46 cases), 66% of which were due to non-cardiac causes, and 77% were due to medical illnesses. The most common first documented rhythm was pulseless electrical activity (38%). Two hundred three cases (85.3%) of IHCA were witnessed at the event; 135 cases (56.7%) were monitored at the event. Non-witnessed cases, monitored cases, night onset, medical illness, metastatic cancer, intubation, and long duration of cardiopulmonary resuscitation were significantly associated with hospital mortality. We identified 91 preventable cases (38%). Respiratory insufficiency (37 cases, 41%) was one of major cause of preventable IHCA. CONCLUSIONS: Witnessed IHCAs in the general ward had a higher rate of survival to hospital discharge; however, monitored cases had a lower rate of survival to hospital discharge. Respiratory insufficiency was a major preventable cause of IHCA. In consideration of the preventable IHCAs, further studies should be performed on monitoring practices in general wards.

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Characteristics and outcome among patients suffering in-hospital cardiac arrest in monitored and non-monitored areas

Cited by 120 publications

References 18 publications

In-hospital cardiac arrests: effect of amended Australian Resuscitation Council 2006 guidelines

In-hospital cardiac arrests: effect of amended Australian Resuscitation Council 2006 guidelines

Ocena częstości występowania wewnątrzszpitalnego nagłego zatrzymania krążenia w Polsce

Clinical Outcomes of Witnessed and Monitored Cases of In-Hospital Cardiac Arrest in the General Ward of a University Hospital in Korea

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