Outcomes of adults with in-hospital cardiac arrest after implementation of the 2010 resuscitation guidelines

Abstract

BackgroundThe 2015 guidelines for cardiopulmonary resuscitation (CPR) are based on an update of the 2010 guidelines with minor revisions. It is important to assess the 2010 guidelines to ensure their efficacy, which may help promote widespread adoption of the 2015 guidelines. MethodsWe conducted a retrospective observational study in a single center that evaluated patients with in-hospital cardiac arrest (IHCA) between 2006 and 2014. Multivariable logistic regression analysis was used to evaluate associations between independent variables and outcomes. ResultsA total of 1525 patients were included. For patients with initial non-shockable rhythms, the elapsed time to first adrenaline injection was significantly shorter for patients who received CPR according to the 2010 guidelines (2010-CPR) than for those who were treated according to the 2005 guidelines (2005-CPR). During post-cardiac arrest care, the percentage of patients with fever was significantly lower and the implementation of critical interventions was significantly higher in patients who received 2010-CPR than in those who received 2005-CPR. After adjusting for the effects of confounding factors, patients who received 2010-CPR had improved neurological outcomes (odds ratio [OR], 1.75; 95% confidence interval [CI], 1.05–2.93; p=0.03) and survival (OR, 1.50; 95% CI, 1.06–2.12; p=0.02) at hospital discharge than patients who received 2005-CPR. ConclusionsHospital adoption of the 2010 guidelines may improve the neurological and survival outcomes for IHCA patients. This improvement might result from an emphasis on the importance of high-quality CPR, post-cardiac arrest care, and teamwork in the 2010 guidelines.