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Adherence to guidelines is associated with improved survival following in-hospital cardiac arrest

Fredrik Hessulf1, Johan Herlitz2, Araz Rawshani3

  • 1Department of Anaesthesiology and Intensive Care Medicine, Halland Hospital, SE-301 85 Halmstad, Sweden; Department of Molecular and Clinical Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Resuscitation
|July 25, 2020
PubMed

Insights

Adhering to cardiopulmonary resuscitation (CPR) guidelines after in-hospital cardiac arrest significantly improves survival rates and neurological function for patients with both shockable and non-shockable rhythms. Strict adherence to CPR protocols is crucial for better patient outcomes.

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Clinical Research

Background:

  • Resuscitation guidelines often specify maximum delay times for critical interventions following cardiac arrest.
  • In-hospital cardiac arrest (IHCA) survival rates are influenced by the timeliness and adherence to established treatment protocols.

Purpose of the Study:

  • To investigate the association between adherence to cardiopulmonary resuscitation (CPR) guidelines and patient survival following in-hospital cardiac arrest (IHCA).
  • To specifically examine the impact of delays in treatment initiation on outcomes in IHCA patients.

Main Methods:

  • Utilized the Swedish Registry for CPR, analyzing data from 3212 patients with shockable rhythms and 9113 with non-shockable rhythms (2008-2017).
  • Included adult patients (≥18 years) with witnessed IHCA where resuscitation was initiated.
  • Defined adherence based on time to calling for help, CPR initiation (within 1 min), and defibrillation (within 3 min for shockable rhythms).

Main Results:

  • For shockable rhythms, 30-day survival was 66.1% with guideline adherence versus 46.5% without (aOR 1.84).
  • For non-shockable rhythms, 30-day survival was 22.8% with adherence versus 16.0% without (aOR 1.43).
  • Improved neurological function was observed in survivors treated according to guidelines for both rhythm types.

Conclusions:

  • Adherence to CPR guidelines is significantly associated with increased survival probability and better neurological outcomes in IHCA patients.
  • Enhancing adherence to established CPR protocols holds the potential to improve overall cardiac arrest survival rates.
Abstract

Keywords:
Cardiopulmonary resuscitationChain of survivalGuidelinesIn-hospital cardiac arrest

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