Improving Survival Rate of Patients with In-Hospital Cardiac Arrest: Five Years of Experience in a Single Center in Korea

Abstract

The aim of this study was to describe the cause of the recent improvement in the outcomes of patients who experienced in-hospital cardiac arrest. We retrospectively analyzed the in-hospital arrest registry of a tertiary care university hospital in Korea between 2005 and 2009. Major changes to the in-hospital resuscitation policies occurred during the study period, which included the requirement of extensive education of basic life support and advanced cardiac life support, the reformation of cardiopulmonary resuscitation (CPR) team with trained physicians, and the activation of a medical emergency team. A total of 958 patients with in-hospital cardiac arrest were enrolled. A significant annual trend in in-hospital survival improvement (odds ratio = 0.77, 95% confidence interval 0.65-0.90) was observed in a multivariate model. The adjusted trend analysis of the return of spontaneous circulation, six-month survival, and survival with minimal neurologic impairment upon discharge and six-months afterward revealed similar results to the original analysis. These trends in outcome improvement throughout the study were apparent in non-ICU (Intensive Care Unit) areas. We report that the in-hospital survival of cardiac arrest patients gradually improved. Multidisciplinary hospital-based efforts that reinforce the Chain of Survival concept may have contributed to this improvement.

Statistics of rapid response team's work in the training and research hospital of Ordu between 2010-2013: A retrospective study.

“…It is reported that patients resuscitated early and observed in ICU may have longer life expectancy and the critical point here is early diagnosis (13). In our study we found that 58.1% of the interventions ended with exitus and 10.6% of the cases were transferred to ICU after the first intervention.…”

Comparison of in-Hospital Cardiopulmonary Resuscitation Results Before and After the Introduction Code Blue

“…9,33 In cases with an initial rhythm of VF/pVT, the ROSC was 72-64%, 24 hour survival was 35-41% and hospital discharge is 36-24%. 14,17,18,26 These rates are higher compared to those observed in cases with an initial rhythm of asystole. [18][19][20] In our study, the ROSC, the 24 hour survival and the hospital discharge rates of patients with an initial VF/pVT rhythm at the time of arrest increased from 26.8%, 24.2% and 22.2%, respectively before the introduction of code blue (Group 1) to 73.27%, 75.8% and 77.8%, respectively, after code blue (Group 2).…”

“…The ROSC with an initial rhythm of asystole was observed to be as low as 35%. 26 24 hour survival (10-35%) and hospital discharge rates (5-7.5%) were also low. 9,33 In cases with an initial rhythm of VF/pVT, the ROSC was 72-64%, 24 hour survival was 35-41% and hospital discharge is 36-24%.…”

“…26 The hospital discharge rate was 18% in a study including 36,902 patients. 19 In other studies, the hospital discharge rates was 13% in the U.S, 15% in Canada, 15% and 17%.…”

“…12,26 In a study by Shin et al, the duration of CPR varied between 26.6 and 30.5 min. 26 Other studies reported that patients in which the resuscitation procedure lasted more than 10 min had higher mortality, whereas survival rates increased after the resuscitations was successfully completed in less than 10 min. 19,27 The duration of resuscitation was 12.3-18.9 min.…”