Long-term prognosis among survivors after in-hospital cardiac arrest

Abstract

Aim: To describe mortality and morbidity in the 2 years after discharge from hospital among patients surviving an in-hospital cardiac arrest. Patients: All patients over a 2-year period who survived in-hospital cardiac arrest and could be discharged from hospital. Setting: Sahlgrenska University Hospital in Göteborg. Methods: The patients were followed prospectively for 2 years after discharge from hospital and evaluated in terms of mortality and morbidity and cerebral performance categories (CPC) score. CPC score was estimated by reference to the case notes. Results: In all, 216 patients suffered in-hospital cardiac arrest and the resuscitation team was alerted: 79 patients (36.6%) were discharged alive. Among these 79 patients, 26.6% died, 7.8% developed a confirmed myocardial infarction and 1.3% developed a stroke during the subsequent 2 years. Among patients with a CPC score >1 at discharge ( n=15), mortality was 66.7% as compared with 17.5% among patients with a CPC score of 1 ( P=0.0008). Among patients aged >68 years (median) mortality was 39.5 versus 14.6% among patients ≤68 years of age ( P=0.002). In all, 71% required rehospitalization for any reason and 51% required rehospitalization due to a cardiac cause. At hospital discharge 81% of all survivors had a CPC score of 1 and among survivors 2 years later 89% had a CPC score of 1. Conclusion: Among survivors of in-hospital arrest ∼75% survived the subsequent 2 years. Survival was related to age and CPC score at discharge. Among survivors after 2 years the vast majority had a relatively good cerebral performance.