The incidence and characteristics of bacteremia in cardiac arrest

Despite improvements in both preventative and post-event care, cardiac arrest still occurs frequently with high morbidity and mortality. Bacteremia is a potential cause or complication of cardiac arrest that has received increasing notoriety in recent years.

To identify the incidence of and predictive factors for bacteremia in both inside and outside of hospital cardiac arrest patients.

Retrospective, single centered, cohort study conducted at an academic medical center. Patients 18 years of age or older with cardiac arrest and blood cultures drawn within 24 h of the event were included.

Two-hundred sixty-three cardiac arrest patients were included, of which forty-three patients (16.3%) were bacteremic. Patients with bacteremia had higher rates of home parenteral nutrition and a history of known infection before cardiac arrest. Bacteremic patients had a higher blood urea nitrogen (30 mg/dL vs. 23, p = 0.02), serum creatinine (2.40 mg/dL  vs. 1.70, p = 0.05), and troponin (0.39 ng/mL vs. 0.12, p = 0.03) compared with the non-bacteremic group. There were no differences in duration of mechanical ventilation, hospital length of stay or ICU length of stay. Mortality at 28-days was higher in the bacteremic group (79%) compared to the non-bacteremic group (60.9%, p = 0.02). No factors associated with bacteremia were identified.

Bacteremia was observed in 16.3% of patients, with significant differences between the bacteremic and non-bacteremic group regarding home parenteral nutrition and known infection before the event, cardiac arrest characteristics (blood urea nitrogen, serum creatinine, and troponin), and 28-day mortality.