Abstract
Background and Purpose: In-hospital cardiac arrest (IHCA) has high mortality rate, which needs more research. This multi-center study aims to evaluate potential risk factors for mortality in patients after IHCA.Methods: Data for this study retrospectively enrolled IHCA patients from 14 regional hospitals, two district hospitals, and five medical centers between 2013 June and 2018 December. The study enrolled 5,306 patients and there were 2,871 patients in subgroup of intensive care unit (ICU) and emergency room (ER), and 1,894 patients in subgroup of general wards.Results: As for overall IHCA patients, odds ratio (OR) for mortality was higher in older patients (OR = 1.69; 95% CI:1.33–2.14), those treated with ventilator (OR = 1.79; 95% CI:1.36–2.38) and vasoactive agents (OR = 1.88; 95% CI:1.45–2.46). Whereas, better survival was reported in IHCA patients with initial rhythm as ventricular tachycardia (OR = 0.32; 95% CI: 0.21–0.50) and ventricular fibrillation (OR = 0.26; 95% CI: 0.16–0.42). With regard to ICU and ER subgroup, there was no mortality difference among different nursing shifts, whereas for patients in general wards, overnight shift (OR = 1.83; 95% CI: 1.07–3.11) leads to poor outcome.Conclusion: For IHCA patients, old age, receiving ventilator support and vasoactive agents reported poor survival. Overnight shift had poor survival for IHCA patients in general wards, despite no significance in overall and ICU/ER subgroups.
Highlights
In-hospital cardiac arrest (IHCA) has high mortality rate [1]
This study was conducted to evaluate the potential risk factors for mortality in patients after IHCA. This cross-sectional study analyzed the IHCA data set of The Taiwan Clinical Performance Indicator (TCPI) system, which was founded by the Joint Commission of Taiwan (JCT) in 2011
In the multivariable logistic regression model, odds ratio (OR) for mortality was higher in older patients, those receiving ventilator support before ALS, and those receiving vasoactive agents during ALS in the overall IHCA patient group (Table 3)
Summary
In-hospital cardiac arrest (IHCA) has high mortality rate [1]. The majority of data are derived from the American Heart Association’s Get With The Guidelines-Resuscitation (GWTG-R) registry, which reported 9 to 10 IHCA cases per 1,000 admissions from 2008 to 2017 [2, 3].Despite successful resuscitation, only few resuscitated patients have good neurologic conditions at discharge [4]. In-hospital cardiac arrest (IHCA) has high mortality rate [1]. The majority of data are derived from the American Heart Association’s Get With The Guidelines-Resuscitation (GWTG-R) registry, which reported 9 to 10 IHCA cases per 1,000 admissions from 2008 to 2017 [2, 3]. Only few resuscitated patients have good neurologic conditions at discharge [4]. Compared to other critical cardiovascular conditions, including stroke, myocardial infarction, and OHCA, IHCA has received little attention [1]. This study was conducted to evaluate the potential risk factors for mortality in patients after IHCA. In-hospital cardiac arrest (IHCA) has high mortality rate, which needs more research. This multi-center study aims to evaluate potential risk factors for mortality in patients after IHCA
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