Outcomes of In-hospital Cardiopulmonary Resuscitation in Patients with and without History of Heart Transplantation: Results from National Inpatient Sample 2000-2014

Abstract

Introduction According to the American Heart Association update in 2017, 2,804 patients underwent heart transplantation (HT) in the US in 2015. The outcome of cardiopulmonary resuscitation (CPR) in HT patients in comparison to patients without HT during hospitalization is not known. Methods We utilized the National Inpatient Sample database from years 2000 - 2014. We selected non-pregnant patients over the age of 18 who underwent CPR during admission in US hospitals over the specified period. We selected patients with ventricular fibrillation (VF) and cardiac arrest based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Clinical Classification Software-Diagnoses codes supplied by the Healthcare Cost and Utilization Project (HCUP). Non-VF patients were cardiac arrest patients excluding VF. We used STATA version 13.0 (College Station, TX) for database analysis. Results Our study population consisted of 280,790 discharge records. Baseline characteristics are presented in Table 1 . Multivariable logistic regression analysis of mortality and length of stay (LOS) in patients with in-hospital cardiopulmonary resuscitation for cardiac arrest, VF arrest and non-VF arrest with or without HT did not reach statistical significance. Discussion Heart transplant patients are at increased risk of ventricular arrhythmias and death from accelerated atherosclerosis of transplanted heart (cardiac allograft vasculopathy, CAV) or allograft rejection. These patients are susceptible to bradycardic events and electromechanical dissociation related to CAV. Conclusion Through our study, we can conclude that the outcome of HT patients who undergo CPR is the same as those without history of HT.