CLINICAL PARTICULARITIES IN HYPERTENSIVE PATIENTS WITH RESUSCITATED CARDIAC ARREST ADMITTED TO AN EMERGENCY HOSPITAL

Abstract

Objective: to assess the comorbidities, clinical particularities and laboratory findings in hypertensive patients admitted for resuscitated cardiac arrest. Design and method: A retrospective study of the medical records of 103 patients with resuscitated cardiac arrest admitted in Clinical Emergency Hospital, Internal Medicine Department between August 2014 and October 2018. Results: The study group consisted of 58 hypertensive patients from 103 patients with resuscitated cardiac arrest. Gender distribution: 60% male (35 patients) and 40% female (23 patients). Patients were aged between 41 and 93 years old, with an average age of 70 years. 67.25% of patients presented a cardiac arrest during hospitalization and 32.75% in pre-hospital setting. In 69% of cases the patients repeated the episode. 56.9% of patients presented with leukocytosis, and also 56.9% of patients had anemia (84.84% mild anemia, 3.03% moderated anemia, 12.12% severe anemia). At 65.51% of patients a blood clotting disorder was identified (based on INR values); 20.7% had thrombocytopenia and 13.8% thrombocytosis. Chronic kidney disease evaluated by MDRD equation was encountered in 83.13% of patients at admission, with the following staging: 22.41% stage G2, 12.06% G3a, 15.51% G3b, 17.28% G4, 8.62% G5. As electrolytes imbalance we noticed hyponatremia in 24.13% of cases, hypokalemia in 20.68% and hyperkalemia in 8.62%. 36.20% of patients had acidosis and 8.62% alkalosis. Regarding cardiovascular diseases, 63.79% of patients had heart failure (27% NYHA class II, 46% % NYHA class III and 27% NYHA class IV), 24.13% had a history of stroke, 19% previous myocardial infarction, 6.9% chronic peripheral arterial disease. Other comorbidities: 41.37% COPD, 37.93% diabetes mellitus Conclusions: The most common comorbidities in hypertensive patients admitted for resuscitated cardiac arrest were heart failure and chronic kidney disease. Diabetes mellitus is commonly associated with hypertension in patients with resuscitated cardiac arrest. Hyponatremia and hypokalemia are common in these patients.