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In-hospital cardiac arrest: different wards show different survival patterns.

S Smith1, E A Shipton, J E Wells

  • 1Department of Anaesthesia, Christchurch Hospital, and University of Otago, Christchurch, New Zealand.

Anaesthesia and Intensive Care
|November 21, 2007
PubMed
Summary

Outcomes for in-hospital cardiac arrests vary significantly by clinical area. Cardiology wards showed higher resuscitation and survival rates compared to medical wards, highlighting the need for tailored resuscitation training.

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Area of Science:

  • Cardiology
  • Emergency Medicine
  • Health Services Research

Background:

  • In-hospital cardiac arrests (IHCA) outside critical care units are common.
  • Outcomes for IHCA can vary based on the clinical setting.
  • Understanding these variations is crucial for improving patient care and training.

Purpose of the Study:

  • To investigate the characteristics and outcomes of IHCA in non-critical care areas.
  • To compare resuscitation and survival rates across different clinical areas within a hospital.
  • To identify implications for health professional resuscitation training.

Main Methods:

  • A prospective register of adult IHCA in non-critical care areas at Christchurch Hospital was compiled.
  • Data were collected from January 2001 to December 2004.
  • Outcomes including return of spontaneous circulation and survival to discharge were analyzed, with adjustments for rhythm, age, gender, and time of day.

Main Results:

  • Overall, 243 cardiac arrests were recorded.
  • The overall return of spontaneous circulation was 38.7%, and survival to discharge was 21.0%.
  • Cardiology wards demonstrated the highest rates of successful resuscitation (52.2%) and survival to discharge (41.3%), significantly outperforming medical wards.

Conclusions:

  • Hospital-wide survival rates for IHCA do not accurately represent outcomes in specific clinical areas.
  • Significant differences in IHCA outcomes exist across clinical areas, reflecting variations in staff experience.
  • These findings underscore the importance of specialized resuscitation training and the potential value of national resuscitation registries for detailed outcome analysis.