In-hospital cardiac arrests admitted alive in intensive care units: Insights from the CubRéa database

Bailleul, Clotilde; Puymirat, Étienne; Aegerter, P.; Guidet, Bertrand; Guérot, Emmanuel; Augy, Jean Loup; Bréchot, Nicolas; Diehl, Jean‐Luc; Fagon, Jean-Yves; Hermann, Bertrand; Novara, Ana; Ortuno, Sofia; Younan, Romy; Danchin, Nicolás; Cariou, Alain; Aïssaoui, Nadia

doi:10.1016/j.jcrc.2022.154003

Cited by 3 publications

(7 citation statements)

References 32 publications

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“…examined key features of patients admitted after an IHCA and trends of admissions related to IHCA between 1997 and 2015. They found that the proportion of ICU admissions following IHCA increased over time from 2.78 to 3.83% ( P < 0.001) 19 . The proportion of IHCA‐related ICU admissions was similar to the 3.9% observed in our study, even though the study periods were remarkably different (18 vs 7 years in our study).…”

Section: Discussionsupporting

confidence: 85%

“…They found that the proportion of ICU admissions following IHCA increased over time from 2.78 to 3.83% (P < 0.001). 19 The proportion of IHCArelated ICU admissions was similar to the 3.9% observed in our study, even though the study periods were remarkably different (18 vs 7 years in our study). Although crude ICU mortality decreased from 78 to 62.5% by the end of their study period, this is still significantly higher than the ICU mortality of cardiac arrestrelated admissions of 39.4% in our study from 2015 to 2019.…”

Section: Comparison With Similar Studiessupporting

confidence: 88%

“…Outcomes of patients admitted to ICU following IHCA are scarcely reported. In a recently published database study of the Greater Paris area ICU, 19 Bailleul et al . examined key features of patients admitted after an IHCA and trends of admissions related to IHCA between 1997 and 2015.…”

Section: Discussionmentioning

confidence: 99%

“…We used 2013-2014 as the baseline period, albeit with a more complete dataset (more hospitals completed data submission on time since the first study) compared to the study by Jones et al 17 Outcomes of patients admitted to ICU following IHCA are scarcely reported. In a recently published database study of the Greater Paris area ICU, 19 Bailleul et al…”

Section: Comparison With Similar Studiesmentioning

confidence: 99%

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Epidemiology of in‐hospital cardiac arrest patients admitted to the intensive care unit in Australia: a retrospective observational study

Veerappa

Orosz

Bailey³

et al. 2023

Internal Medicine Journal

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BackgroundIn‐hospital cardiac arrest (IHCA) affects approximately 3000 patients annually in Australia. Introduction of the National Standard for Deteriorating Patients in 2011 was associated with reduced IHCA‐related intensive care unit (ICU) admissions and reduced in‐hospital mortality of such patients.AimsTo assess whether the reduction in IHCA‐related ICU admissions from hospital wards seen following the implementation of the national standard (baseline period 2013–2014) was sustained over the follow‐up period (2015–2019) in Australia.MethodsA multi‐centre retrospective cohort study to compare the characteristics and outcomes of IHCA admitted to the ICU between baseline and follow‐up periods. The primary outcome was the proportion of patients admitted to ICU from the ward following IHCA. Secondary outcomes included ICU and hospital mortality of IHCA‐related ICU admissions. Data were analysed using hierarchical multivariable logistic regression.ResultsThe proportion of cardiac arrest‐related admissions from the ward was lower in the follow‐up period when compared to baseline (4.1 vs 3.8%; P = 0.04). Such patients had lower illness severity and were more likely to have limitations of medical treatment at admission. However, after adjustment for severity of illness, the likelihood of being admitted to ICU following cardiac arrest on the ward increased in the follow‐up period (odds ratio (OR) 1.13 (1.05–1.22); P = 0.001). Hospital mortality was lower in the follow‐up period (50.3 vs 46.3%; P = 0.02), but after adjustment the likelihood of death did not differ between the periods (OR 1.0 (0.86–1.17); P = 0.98).ConclusionAfter adjustment for the severity of illness, the likelihood of being admitted to ICU after IHCA slightly increased in the follow‐up period.

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Section: Discussionsupporting

confidence: 85%

Section: Comparison With Similar Studiessupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Comparison With Similar Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Epidemiology of in‐hospital cardiac arrest patients admitted to the intensive care unit in Australia: a retrospective observational study

Veerappa

Orosz

Bailey³

et al. 2023

Internal Medicine Journal

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“…In addition, ICU patients with alcohol-related liver disease have higher 5-year mortality and readmission rates (66). Real-world CQRs data may support context-specific research questions (67–69), shed light on specific patient groups (27, 70, 71), validate findings in low-resource settings (34), facilitate ICU cost-analysis (72, 73), and global collaborations (74).…”

Section: Evidence Generated To Understand Case-mix and Outcomes Of Ic...mentioning

confidence: 99%

National ICU Registries as Enablers of Clinical Research and Quality Improvement

Salluh,

Quintairos,

Dongelmans

et al. 2023

Critical Care Medicine

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Objectives: Clinical quality registries (CQRs) have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. This narrative review describes the challenges, proposed solutions, and evidence generated by National ICU registries as facilitators for research and quality improvement. Data Sources: English language articles were identified in PubMed using phrases related to ICU registries, CQRs, outcomes, and case-mix. Study Selection: Original research, review articles, letters, and commentaries, were considered. Data Extraction: Data from relevant literature were identified, reviewed, and integrated into a concise narrative review. Data Synthesis: CQRs have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. The initial experience in European countries and in Oceania ensured that through locally generated data, ICUs could assess their performances by using risk-adjusted measures and compare their results through fair and validated benchmarking metrics with other ICUs contributing to the CQR. The accomplishment of these initiatives, coupled with the increasing adoption of information technology, resulted in a broad geographic expansion of CQRs as well as their use in quality improvement studies, clinical trials as well as international comparisons, and benchmarking for ICUs. Conclusions: ICU registries have provided increased knowledge of case-mix and outcomes of ICU patients based on real-world data and contributed to improve care delivery through quality improvement initiatives and trials. Recent increases in adoption of new technologies (i.e., cloud-based structures, artificial intelligence, machine learning) will ensure a broader and better use of data for epidemiology, healthcare policies, quality improvement, and clinical trials.

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Trends in Incidence and Outcomes of Cardiac Arrest Occurring in Swedish ICUs

Flam,

Andersson Franko,

Skrifvars

et al. 2023

Critical Care Medicine

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Objective: To determine temporal trends in the incidence of cardiac arrest occurring in the ICU (ICU-CA) and its associated long-term mortality. Design: Retrospective observational study. Setting: Swedish ICUs, between 2011 and 2017. Patients: Adult patients (≥18 yr old) recorded in the Swedish Intensive Care Registry (SIR). Interventions: None. Measurements and Main Results: ICU-CA was defined as a first episode of cardiopulmonary resuscitation and/or defibrillation following an ICU admission, as recorded in SIR or the Swedish Cardiopulmonary Resuscitation Registry. Annual adjusted ICU-CA incidence trend (all admissions) was estimated using propensity score-weighted analysis. Six-month mortality trends (first admissions) were assessed using multivariable mixed-effects logistic regression. Analyses were adjusted for pre-admission characteristics (sex, age, socioeconomic status, comorbidities, medications, and healthcare utilization), illness severity on ICU admission, and admitting unit. We included 231,427 adult ICU admissions. Crude ICU-CA incidence was 16.1 per 1,000 admissions, with no significant annual trend in the propensity score-weighted analysis. Among 186,530 first admissions, crude 6-month mortality in ICU-CA patients was 74.7% (95% CI, 70.1–78.9) in 2011 and 68.8% (95% CI, 64.4–73.0) in 2017. When controlling for multiple potential confounders, the adjusted 6-month mortality odds of ICU-CA patients decreased by 6% per year (95% CI, 2–10). Patients admitted after out-of-hospital or in-hospital cardiac arrest had the highest ICU-CA incidence (136.1/1,000) and subsequent 6-month mortality (76.0% [95% CI, 73.6–78.4]). Conclusions: In our nationwide Swedish cohort, the adjusted incidence of ICU-CA remained unchanged between 2011 and 2017. More than two-thirds of patients with ICU-CA did not survive to 6 months following admission, but a slight improvement appears to have occurred over time.

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In-hospital cardiac arrests admitted alive in intensive care units: Insights from the CubRéa database

Cited by 3 publications

References 32 publications

Epidemiology of in‐hospital cardiac arrest patients admitted to the intensive care unit in Australia: a retrospective observational study

Epidemiology of in‐hospital cardiac arrest patients admitted to the intensive care unit in Australia: a retrospective observational study

National ICU Registries as Enablers of Clinical Research and Quality Improvement

Trends in Incidence and Outcomes of Cardiac Arrest Occurring in Swedish ICUs

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