The Potential Risk Factors for Mortality in Patients After In-Hospital Cardiac Arrest: A Multicenter Study

Area of Science:

• Critical Care Medicine
• Cardiology
• Hospital Medicine

Background:

• In-hospital cardiac arrest (IHCA) presents a significant challenge with high mortality rates.
• Further research is crucial to understand and mitigate IHCA outcomes.
• Identifying risk factors is key to improving patient survival post-cardiac arrest.

Purpose of the Study:

• To investigate potential risk factors associated with mortality in patients experiencing IHCA.
• To analyze survival differences based on patient demographics, interventions, and hospital care settings.

Main Methods:

• A multi-center retrospective study involving 5,306 IHCA patients from June 2013 to December 2018.
• Data collected from regional hospitals, district hospitals, and medical centers.
• Subgroup analyses were performed for intensive care unit (ICU)/emergency room (ER) and general ward patients.

Main Results:

• Older age, ventilator use, and vasoactive agent administration were associated with increased IHCA mortality (ORs ranging from 1.69 to 1.88).
• Initial rhythms of ventricular tachycardia or ventricular fibrillation correlated with better survival (ORs of 0.32 and 0.26, respectively).
• Overnight nursing shifts were linked to poorer outcomes in general ward patients (OR = 1.83), but not in ICU/ER settings.

Conclusions:

• Key predictors of poor survival in IHCA patients include advanced age, mechanical ventilation, and vasoactive drug use.
• Nursing shift timing, specifically overnight shifts, may negatively affect IHCA patient outcomes in general wards.
• Targeted interventions and further investigation into shift-specific care are warranted for IHCA management.