AI Article Synopsis
- The study focused on the incidence and outcomes of in-hospital cardiac arrest (IHCA) in hospitals across a large Italian region over a three-year period (2012-2014).
- A total of 1,539 IHCA events were documented, with a notable incidence of 1.51 arrests per 1,000 admissions, predominantly occurring on the first day of hospitalization and in the morning hours; the average age of patients was 77.
- The findings showed that 35.7% of patients achieved recovery of spontaneous circulation, and 14.8% survived to discharge, with a significant percentage of survivors experiencing good neurological outcomes, influenced by factors like pre-arrest health and cardiac cause of arrest.
Article Abstract
Aims: to report the incidence, characteristics, and outcome of in-hospital cardiac arrest (IHCA) in a large Italian region.
Setting: all hospitals participating in the IHCA Registry Initiative of Piedmont.
Methods: observational cohort study in adult (>18year old) inpatients resuscitated from IHCA during three consecutive years (2012-2014). The main outcome measures were IHCA incidence and survival to hospital discharge.
Results: A total of1539 arrests in adult inpatients were recorded in the study period, yielding an overall incidence of 1.51 arrests/1000 admissions. The incidence was highest at day 1 after hospital admission and in the morning hours, with a peak at 9.00 a.m. Median age was 77 (interquartile range 68-83) years. The presenting rhythm was ventricular fibrillation/pulseless ventricular tachycardia in 291/1539 (18.9%) cases. A total of 549/1539 (35.7%) patients achieved recovery of spontaneous circulation (ROSC) and 228/1539(14.8%) survived hospital discharge, with 207 (90.8%) of the latter having good neurological outcome (Cerebral Performance Categories [CPC] 1 or 2).After adjustment for major confounders, a pre-arrest CPC=1, a cardiac cause of arrest, a shockable presenting rhythm, and a shorter duration of resuscitation were independently associated with a higher likelihood of survival to discharge.
Conclusions: in this Italian registry the incidence of IHCA and its circadian distribution were comparable to those in the NCAA registry in the UK. Patients were older and had a lower ROSC rate than these observed in other large IHCA registries, but post-ROSC survival rate and factors affecting survival to discharge were similar.
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| http://dx.doi.org/10.1016/j.resuscitation.2017.06.020 | DOI Listing |
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