Volume 14 Issue 3
May  2023
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ZHAO Tingting, ZHAO Yuanyuan, XING Jihong. Analysis of Clinical Characteristics and Resuscitation Outcomes of Adult Patients with In-hospital Cardiac Arrest[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 536-542. doi: 10.12290/xhyxzz.2022-0623
Citation: ZHAO Tingting, ZHAO Yuanyuan, XING Jihong. Analysis of Clinical Characteristics and Resuscitation Outcomes of Adult Patients with In-hospital Cardiac Arrest[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(3): 536-542. doi: 10.12290/xhyxzz.2022-0623

Analysis of Clinical Characteristics and Resuscitation Outcomes of Adult Patients with In-hospital Cardiac Arrest

doi: 10.12290/xhyxzz.2022-0623
Funds:

National Natural Science Foundation of China 82072127

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  • Corresponding author: XING Jihong, E-mail: xingjh@jlu.edu.cn
  • Received Date: 2022-10-27
  • Accepted Date: 2023-03-17
  • Available Online: 2023-03-21
  • Publish Date: 2023-05-30
  •   Objective  To analyze the clinical features and resuscitation outcome of adult patients with cardiac arrest (CA) in intensive care unit, and discuss the related factors affecting the success rate of cardiopulmonary resuscitation in adult patients with CA.  Methods  The clinical data of CA patients in the intensive care unit of the First Hospital of Jilin University from September 2019 to December 2020 were retrospectively analyzed. According to the outcome indicators, the patients were divided into return of spontaneous circulation (ROSC) group and non-ROSC group, survival-discharge group and death group. The relevant factors affecting resuscitation outcome were discussed.  Results  A total of 351 patients with CA were included in this study, including 206 males and 145 females; the median age was 63 years. There were 191 patients with cardiogenic CA and 267 patients with non-defibrillation rhythm (cardiac arrest and no electrical activity) at the onset of CA. After treatment with CPR, 152 patients had ROSC, of whom 42 survived and were discharged. Univariate Logistic regression analysis showed that coronary artery disease, non-defibrillation rhythm, no defibrillation rhythm during resuscitation, no electric defibrillation, and no emergency endotracheal intubation were the possible factors that reduced the incidence of ROSC. Young age, CPR duration ≤30 min, and small cumulative dose of epinephrine were the possible factors that increased the incidence of ROSC. Non-cardiogenic etiology, non-defibrillable rhythm, no electric defibrillation, and no defibrillable rhythm during resuscitation decreased the likelihood of survival and discharge, whereas CPR duration ≤30 min and a small cumulative dose of epinephrine increased the likelihood of survival and discharge. Multivariate Logistic regression analysis showed that CPR duration > 30 min was an independent risk factor for ROSC, and young age, emergency tracheal intubation, and small cumulative epinephrine dose were independent protective factors for ROSC. CPR duration > 30 min was an independent risk factor for survival and discharge, and cardiogenic etiology and presence of defibrillable rhythm during resuscitation were independent protective factors for survival and discharge.  Conclusions  CPR duration, cumulative epinephrine dose, CA initial rhythm, electric defibrillation, and emergence of defibrillable rhythm during resuscitation are associated factors for ROSC as well as survival and discharge, and CPR duration > 30 min is an independent risk factor. Clinical attention should be paid to these factors in order to improve the outcome of cardiopulmonary resuscitation.
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  • [1] 周夷霞, 韩文文, 宋丹丹. 心脏骤停患者心肺复苏后影响自主循环及预后的因素[J]. 心电与循环, 2020, 39: 251-255. https://www.cnki.com.cn/Article/CJFDTOTAL-XDXZ202003012.htm
    [2] Andersen LW, Holmberg MJ, Berg KM, et al. In-Hospital Cardiac Arrest: A Review[J]. JAMA, 2019, 321: 1200-1210. doi:  10.1001/jama.2019.1696
    [3] Stankovic N, Holmberg MJ, Hoybye M, et al. Age and sex differences in outcomes after in-hospital cardiac arrest[J]. Resuscitation, 2021, 165: 58-65. doi:  10.1016/j.resuscitation.2021.05.017
    [4] Shao F, Li CS, Liang LR, et al. Incidence and outcome of adult in-hospital cardiac arrest in Beijing, China[J]. Resuscitation, 2016, 102: 51-56. doi:  10.1016/j.resuscitation.2016.02.002
    [5] Kantamineni P, Emani V, Saini A, et al. Cardiopulmonary resuscitation in the hospitalized patient: impact of system-based variables on outcomes in cardiac arrest[J]. Am J Med Sci, 2014, 348: 377-381. doi:  10.1097/MAJ.0000000000000290
    [6] 刘百求, 李静, 王美堂. 146例院内心搏骤停患者自主循环恢复的影响因素分析[J]. 临床急诊杂志, 2020, 21: 341-345. doi:  10.13201/j.issn.1009-5918.2020.05.001
    [7] Li H, Wu TT, Liu PC, et al. Characteristics and outcomes of in-hospital cardiac arrest in adults hospitalized with acute coronary syndrome in China[J]. Am J Emerg Med, 2019, 37: 1301-1306.
    [8] Wang CH, Huang CH, Chang WT, et al. Associations among gender, marital status, and outcomes of adult in-hospital cardiac arrest: A retrospective cohort study[J]. Resuscitation, 2016, 107: 1-6. doi:  10.1016/j.resuscitation.2016.07.005
    [9] Israelsson J, Persson C, Stromberg A, et al. Is there a difference in survival between men and women suffering in-hospital cardiac arrest?[J]. Heart & Lung, 2014, 43: 510-515. doi:  10.3969/j.issn.1009-0126.2014.05.020
    [10] Narayan SM, Wang PJ, Daubert JP. New Concepts in Sudden Cardiac Arrest to Address an Intractable Epidemic: JACC State-of-the-Art Review[J]. J Am Coll Cardiol, 2019, 73: 70-88. http://www.onacademic.com/detail/journal_1000041588108199_6c09.html
    [11] 黎敏, 宋维, 吕雪, 等. 心肺复苏Utstein模式注册登记研究: 急性心肌梗死导致心脏骤停的流行病学调查研究[J]. 中华急诊医学杂志, 2014, 23: 1385-1388. doi:  10.3760/cma.j.issn.1671-0282.2014.12.019
    [12] Wallmuller C, Meron G, Kurkciyan I, et al. Causes of in-hospital cardiac arrest and influence on outcome[J]. Resuscitation, 2012, 83: 1206-1211. doi:  10.1016/j.resuscitation.2012.05.001
    [13] 钱欣, 林世荣. 初始心律对院内心搏骤停患者预后的影响[J]. 中华急诊医学杂志, 2017, 26: 202-205. doi:  10.3760/cma.j.issn.1671-0282.2017.02.017
    [14] Meaney PA, Nadkarni VM, Kern KB, et al. Rhythms and outcomes of adult in-hospital cardiac arrest[J]. Crit Care Med, 2010, 38: 101-108. doi:  10.1097/CCM.0b013e3181b43282
    [15] Shah P, Smith H, Olarewaju A, et al. Is Cardiopulmonary Resuscitation Futile in Coronavirus Disease 2019 Patients Experiencing In-Hospital Cardiac Arrest?[J]. Crit Care Med, 2021, 49: 201-208. http://pubmed.ncbi.nlm.nih.gov/33093278/
    [16] Lim ZJ, Ponnapa Reddy M, Afroz A, et al. Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: A systematic review and meta-analysis[J]. Resuscitation, 2020, 157: 248-258. doi:  10.1016/j.resuscitation.2020.10.025
    [17] Ippolito M, Catalisano G, Marino C, et al. Mortality after in-hospital cardiac arrest in patients with COVID-19: A systematic review and meta-analysis[J]. Resuscitation, 2021, 164: 122-129. doi:  10.1016/j.resuscitation.2021.04.025
    [18] Hayek SS, Brenner SK, Azam TU, et al. In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study[J]. BMJ, 2020, 371: m3513. http://doc.paperpass.com/foreign/rgArti2020184886427.html
    [19] Kleinman ME, Brennan EE, Goldberger ZD, et al. Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care[J]. Circulation, 2015, 132: S414-S435. http://europepmc.org/abstract/MED/26472993
    [20] Andersen LW, Granfeldt A, Callaway CW, et al. Association Between Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival[J]. JAMA, 2017, 317: 494-506. doi:  10.1001/jama.2016.20165
    [21] Wong ML, Carey S, Mader TJ, et al. Time to invasive airway placement and resuscitation outcomes after inhospital cardiopulmonary arrest[J]. Resuscitation, 2010, 81: 182-186. doi:  10.1016/j.resuscitation.2009.10.027
    [22] Wang CH, Chen WJ, Chang WT, et al. The association between timing of tracheal intubation and outcomes of adult in-hospital cardiac arrest: A retrospective cohort study[J]. Resuscitation, 2016, 105: 59-65. http://www.onacademic.com/detail/journal_1000039114806110_f5c9.html
    [23] Nolan JP, Sandroni C, Böttiger BW, et al. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care[J]. Intensive Care Med, 2021, 47: 369-421.
    [24] 徐胜勇, 于学忠, 徐军. 胸外按压持续时间与心肺复苏结局关系研究[J]. 临床急诊杂志, 2019, 20: 623-626. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZLC201908007.htm
    [25] Kempton H, Vlok R, Thang C, et al. Standard dose epinephrine versus placebo in out of hospital cardiac arrest: A systematic review and meta-analysis[J]. Am J Emerg Med, 2019, 37: 511-517. http://www.ncbi.nlm.nih.gov/pubmed/30658877
    [26] Loomba RS, Nijhawan K, Aggarwal S, et al. Increased return of spontaneous circulation at the expense of neurologic outcomes: Is prehospital epinephrine for out-of-hospital cardiac arrest really worth it?[J]. J Crit Care, 2015, 30: 1376-1381. http://europepmc.org/abstract/MED/26428074
    [27] Callaway CW. Epinephrine for cardiac arrest[J]. Curr Opin Cardiol, 2013, 28: 36-42.
    [28] Perkins GD, Ji C, Deakin CD, et al. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest[J]. N Engl J Med, 2018, 379: 711-721.
    [29] Soar J, Bottiger BW, Carli P, et al. European Resuscita-tion Council Guidelines 2021: Adult advanced life support[J]. Resuscitation, 2021, 161: 115-151.
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