Long-term prognosis among survivors after in-hospital cardiac arrest

To describe mortality and morbidity in the 2 years after discharge from hospital among patients surviving an in-hospital cardiac arrest.

All patients over a 2-year period who survived in-hospital cardiac arrest and could be discharged from hospital.

Sahlgrenska University Hospital in Göteborg.

The patients were followed prospectively for 2 years after discharge from hospital and evaluated in terms of mortality and morbidity and cerebral performance categories (CPC) score. CPC score was estimated by reference to the case notes.

In all, 216 patients suffered in-hospital cardiac arrest and the resuscitation team was alerted: 79 patients (36.6%) were discharged alive. Among these 79 patients, 26.6% died, 7.8% developed a confirmed myocardial infarction and 1.3% developed a stroke during the subsequent 2 years. Among patients with a CPC score >1 at discharge (n=15), mortality was 66.7% as compared with 17.5% among patients with a CPC score of 1 (P=0.0008). Among patients aged >68 years (median) mortality was 39.5 versus 14.6% among patients < or =68 years of age (P=0.002). In all, 71% required rehospitalization for any reason and 51% required rehospitalization due to a cardiac cause. At hospital discharge 81% of all survivors had a CPC score of 1 and among survivors 2 years later 89% had a CPC score of 1.

Among survivors of in-hospital arrest approximately 75% survived the subsequent 2 years. Survival was related to age and CPC score at discharge. Among survivors after 2 years the vast majority had a relatively good cerebral performance.