Who survives cardiac arrest in the intensive care units?

Abstract

Objective The aim of this study was to evaluate the factors related to outcome regarding in–intensive care unit (ICU) cardiac arrest (IICA) in a university hospital. Patients and Methods Adult nontraumatic ICU patients who sustained IICA were prospectively enrolled. Several patient and event-related variables, as well as outcomes, were recorded and summarized based on the revised Utstein-style template. Results A total of 202 episodes of IICA happened during the study period. Return of spontaneous circulation (ROSC) was achieved in 127 patients (62.9%), whereas the overall survival-to-discharge rate was 15.3% (31 patients). In univariate analysis, a shorter duration of resuscitation and pulseless ventricular tachycardia/ventricular fibrillation (VT/VF) as initial arrest rhythm represented better outcomes. Independent predictors of survival to hospital discharge were VT/VF as the initial rhythm (odds ratio [OR], 3.81; 95% confidence interval [CI], 1.50-9.67; P = .005), lower Acute Physiology and Chronic Health Evaluation II score (OR 0.92, 95% CI 0.87-0.98, P = .008), and shorter resuscitation durations (OR 0.91, 95% CI 0.87-0.96, P < .001). Conclusion Shorter resuscitation duration and initial VT/VF are predictors for both ROSC and hospital survival, whereas lower Acute Physiology and Chronic Health Evaluation II scores predict the latter.