Author + information
- Murtaza A. Sundhu,
- Bilal Alam,
- Alinda Sarma,
- Bilal Saqi,
- Mubbasher Syed,
- Anas SaeedBamashmos and
- Sudhir Dudekonda
There are limited data on in-hospital cardiac arrest, and hence we don’t understand the predictors of outcome in this cohort. This study aims to understand how the admitting diagnosis affects the survival from cardiac arrest and then survival-to-discharge after return of spontaneous circulation.
Institutional review board of the Cleveland Clinic approved the retrospective cross-sectional study for patients who had in-hospital cardiac arrest from March 2015 to June 2016 at Cleveland Clinic-Fairview Hospital. Cardiac arrest/code blue (CA) protocol was activated on 153 patients during the study period of 15 months. Out of 153 patients, 21 were false activation and they were excluded. Data were collected using the electronic medical record for events before, during and after the CA. SPSS was used for statistical analysis.
A total of 132 patients were included in the study. Demographic distribution showed median age of 69.5 years. 59% (78/132) were males, 51% (67/132) had diabetes, 78% (103/132) had hypertension, 46% (61/132) had coronary artery disease, 39% (51/132) had chronic kidney disease, and 38% (50/132) had COPD. The patients were divided into 2 groups, cardiac and non-cardiac, based on the primary organ system affected at admission. Out of the 132 patients, 48 (36%) were in cardiac and 84 (64%) in non-cardiac group. Return of spontaneous circulation (ROSC) was achieved in 27/48 (56%) patients in cardiac and 49/84 (58%) in non-cardiac group (p=0.816). Survival-to-discharge after ROSC was 16/27 (59%) in cardiac and 18/49 (36%) in non-cardiac group (p < 0.0001).
Return of spontaneous circulation was similar between cardiac and non-cardiac group; however, survival-to-discharge after ROSC is significantly higher in patients admitted primarily for cardiac cause. Further studies are needed to define the characteristics of patients achieving ROSC and then survival-to-discharge after in-hospital CA.