Risk factors and comorbidities associated with cardiac arrests and medical emergencies in interventional radiology patients

Abstract

Purpose To investigate the incidence, predictors, and outcomes of medical emergencies in patients undergoing IR procedures at a tertiary care center. Materials and methods Seven-year retrospective review of all medical emergencies in patients undergoing IR procedures at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Medical emergencies included Cardiopulmonary arrest (CPA), or emergencies that required activation of the critical care response team (CCRT). Variables included demographics, procedure details and outcome data including complications and 30-day mortality. Multivariate logistic regression analysis was conducted to identify independent predictors of CPA and 30-day mortality. Results Ninety-four patients (50% male) were included with a median age of 60.5 years. Recent or current ICU admission was recorded in 39 patients (43.8%). Comorbidities included diabetes (50%), hypertension (59.6%), coronary artery disease (25.5%), heart failure (21.5%), ESRD (28.7%), active infection 28 (31%), with ASA3 in 64 patients (68%) and ASA4 in 23 (24.5%). The incidence of CPA and CCRT activation was 0.045% and 0.049%, respectively, among 100,000 patients who underwent IR procedures during the study period. Half the events were with venous procedures, followed by non-vascular (33%) and arterial procedures (10.6%). 30-day mortality was 30.5%. Independent predictors of CPA included pulmonary disease (aOR 16.79, 95% CI 2.334–195.3, p = 0.0097), emergency procedures (aOR 11.63, 95% CI 2.517–72.46, p = 0.0035), general anesthesia (aOR 19.41, 95% CI 1.854–491.8, p = 0.0254), and sedation (aOR 13.04, 95% CI 2.081–118.8, p = 0.0108). Predictors of 30-day mortality were CPA (aOR 9.830, 95% CI 2.439–66.66, p = 0.0045) and hypotension as a complication (aOR 16.81, 95% CI 3.766–122.3, p = 0.0009). Conclusion Our findings highlight the complexity of patients undergoing IR procedures and the importance of identifying high-risk patients to prevent adverse events in the IR setting.