Clinical outcomes of in‑hospital cardiac arrest in a tertiary hospital and factors related to 28‑day survival: A retrospective cohort study

Abstract

OBJECTIVES: The primary aim was to define factors related to the return of spontaneous circulation (ROSC) after in‑hospital cardiac arrest (IHCA), and the secondary aim was to determine factors related to 28‑day mortality in patients admitted to intensive care unit (ICU) after ROSC. METHODS: In this retrospective study, we included the patients who suffered from IHCA in a tertiary hospital between July 2016 and April 2019. Pre‑ and post‑resuscitation characteristics of the patients and event characteristics were defined to reveal the independent factors associated with ROSC and 28‑day survival. RESULTS: A total of 254 patients (median age 73 years, 58.3% males) underwent cardiopulmonary resuscitation (CPR). The ROSC rate was 45.7%. Of all, 51 patients (median age, 63 years, 54.9% males) were admitted to in‑hospital ICUs. The 28‑day survival rate was 31.4%. The independent risk factors were chronic kidney disease (odds ratio [OR], 3.18, 95% confidence interval [CI], 1.37–7.19, P = 0.007), chronic obstructive pulmonary disease (OR, 2.84, 95% CI, 1.23–6.61, P = 0.015), asystole as an initial rhythm (OR, 2.94, 95% CI, 1.27–6.79, P = 0.012), multi‑trauma‑related complications (OR, 21.11, 95% CI, 4.71–94.69, P 2 (OR, 20.86, 95% CI, 2.74–158.65, P = 0.003), Acute Physiology and Chronic Health Evaluation II score >14 (OR, 7.58, 95% CI, 1.06–54.23, P= 0.044) for 28‑day mortality. CONCLUSIONS: Independent risk factors related to ROSC and 28‑day mortality were defined in the study. However, further studies are needed to devise new strategies for increased hospital discharge with preserved neurologic functions.