Abstract
Objective: To determine characteristics and outcome among patients suffering in-hospital cardiac arrest, and assess factors influencing the survival.
Method: From January 2005 to June 2007, data of inpatients who received resuscitation for sudden cardiac arrest were collected by the Utstein style prospectively.
Result: 112 patients were included. 52.7% of cardiac arrest was occurred in coronary care unit and cardiology ward. 84 patients (75.0%) were witnessed immediately after cardiac arrest. Ventricular fibrillation or pulseless ventricular tachycardia was observed as initial cardiac rhythm in 24 patients (21.4%). Average time from collapse to resuscitation was 0.6 minutes, to defibrillation was 4.2 minutes, to intubation was 5.0 minutes, and to administration of epinephrine was 6.2 minutes. Overall, 55 of 112 patients (49.1%) were returned of spontaneous circulation and 13 patients (11.6%) were survived to discharge. 12 patients showed satisfactory neurological recovery (Cerebral performance category 1 or 2). Factors associated with return of circulation were VF/pulseless VT as the initial rhythm (odds ratio: 4.14, 95%CI: 1.45-32.65) and respiratory cause (odds ratio: 6.88, 95%CI: 1.45-32.65). Factors influenced survival to discharge were witness of arrest (odds ratio was not calculated), VF/pulseless VT as the initial rhythm (odds ratio: 12.6, 95%CI: 3.44-46.22), cardiogenic cause (odds ratio: 16.89, 95%CI: 2.12-135.72), and time from collapse to administration of epinephrine (odds ratio: 0.75).
Conclusion: A high survival rate and an excellent neurological function are expected by the cardiogenic arrest. But VF/pulseless VT as the initial rhythm was showed only 21.4% of in-hospital arrest rhythm. To improve the outcome of the in-hospital cardiac arrest, it seems that there was a limit only by the early defibrillation. About non-cardiogenic arrest, it is important to discover the warning sign of cardiac arrest.
