Abstract

ObjectivesResuscitation on in-hospital cardiac arrest (IHCA) is estimated to occur in 200,000 hospitalised patients annually in the US and short-term survival, i.e. 30 days, is reported to be around 15–20%. Even if 30-day survival is a good measure of successful resuscitation, the number of survivors is quite high and a perspective on longer-term outcomes is relevant. AimTo assess long-term mortality among 30-day survivors after an IHCA. Material and methodsAll patients ≥18 years surviving for at least 30 days after an IHCA at Karolinska University Hospital between 1st January 2007 and 31st December 2014 were included. Data regarding the IHCA, patient characteristics, new cardiac, pulmonary or neurological diagnosis and death dates were obtained from complete Swedish national registries. Censor date was set as 10th February 2017. Differences in long-term survival between those with shockable compared to those with non-shockable first rhythm were assessed with Kaplan Meier survival curves, with adjustment for age-adjusted Charlson Co-morbidity Index (AccI). ResultsIn all, 1019 patients suffered an IHCA, of whom 267 (26%) survived for at least 30 days. Out of the 267 patients, 158 (59%) were still alive at the censor date, i.e. 3–10 years after their IHCA. The three year survival ratio was 72%. There was a significant better long-term survival among those with shockable initial rhythm than those with a non-shockable first rhythm that persisted after adjustment for ACCI (adjusted 10-year survival; >75% and >50% respectively, p-value < .01). ConclusionIn conclusion, long-term survival after an IHCA is quite good irrespective of initial rhythm but is related to the burden of baseline co-morbidities.

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