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Aetiology of in-hospital cardiac arrest on general wards

Joonas Tirkkonen1, Heidi Hellevuo2, Klaus T Olkkola3

  • 1Tampere University Hospital, Department of Intensive Care Medicine, P.O. Box 2000, FI-33521 Tampere, Finland; Department of Anaesthesiology and Intensive Care Medicine, Seinäjoki Central Hospital, Finland.

Resuscitation
|August 6, 2016
PubMed

Insights

Cardiac causes underlie half of in-hospital cardiac arrests (IHCAs) on general wards. However, neither cardiac aetiology nor absence of vital sign deterioration predicted long-term survival in IHCA patients.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Internal Medicine

Background:

  • In-hospital cardiac arrests (IHCAs) on general wards are common but their aetiology is poorly understood.
  • Understanding the causes of IHCA is crucial for improving patient outcomes.

Purpose of the Study:

  • To determine the underlying causes of IHCAs on general wards.
  • To investigate the association between aetiology, preceding vital dysfunctions, and long-term survival.

Main Methods:

  • Prospective observational study of 279 adult IHCA patients in a Finnish university hospital.
  • Aetiology determined via autopsy records and consultant clinical judgment.
  • Analysis of preceding vital dysfunctions and association with 180-day survival.

Main Results:

  • Cardiac aetiology was identified in 141 (50.5%) IHCAs, with acute myocardial infarction being the most common (73 cases).
  • Non-cardiac causes included pneumonia (39) and exsanguination (16).
  • No significant difference in preceding objective vital dysfunctions between cardiac and non-cardiac groups; subjective antecedents were more common in cardiac cases.
  • Only shockable primary rhythm, monitored/witnessed event, and low comorbidity score were independently associated with 180-day survival.

Conclusions:

  • Cardiac causes account for half of general ward IHCAs.
  • Both objective and subjective antecedents are frequently observed.
  • Neither cardiac aetiology nor lack of preceding vital sign deterioration independently predicted favorable outcomes.
Abstract

Keywords:
AetiologyIHCAIn-hospital cardiac arrest

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