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Aetiology and outcome in hospitalized cardiac arrest patients

Malin Albert1, Johan Herlitz2, Araz Rawshani3

  • 1Department of Clinical Science and Education, Södersjukhuset, Centre for Resuscitation Science, Karolinska Institutet, Sjukhusbacken 10, 118 83 Stockholm, Sweden.

European Heart Journal Open
|August 11, 2023
PubMed

Insights

Cardiac causes of in-hospital cardiac arrest (IHCA) are evenly distributed with non-cardiac causes. Myocardial ischemia and other cardiac causes significantly improve 30-day survival and neurological outcomes in IHCA patients.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Epidemiology

Background:

  • In-hospital cardiac arrests (IHCAs) represent a critical patient safety concern.
  • Understanding the diverse aetiologies of IHCA is crucial for improving patient outcomes.

Purpose of the Study:

  • To investigate the various causes of IHCAs.
  • To analyze the association between IHCA aetiologies and 30-day survival rates.
  • To evaluate the impact of aetiologies on neurological outcomes post-IHCA.

Main Methods:

  • A nationwide observational study utilizing national registry data.
  • Categorization of 22 specific IHCA aetiologies into cardiac vs. non-cardiac groups.
  • Analysis of 30-day survival and neurological outcomes (Cerebral Performance Category scale 1-2) at discharge for 4320 IHCA patients (April 2018 - December 2020).

Main Results:

  • Cardiac causes accounted for approximately 50% of IHCAs, showing a 48.4% 30-day survival rate versus 18.7% for non-cardiac causes (P < 0.001).
  • Myocardial ischemia was the most frequent cardiac aetiology (29.9%), followed by pulmonary causes (21.4%) and other cardiac causes (19.6%).
  • Myocardial ischemia demonstrated the best neurological outcomes, while infection-related IHCAs had the lowest odds ratio for favorable outcomes (OR 0.06).

Conclusions:

  • IHCA aetiologies were evenly distributed between cardiac and non-cardiac causes in this study population.
  • Cardiac causes, particularly myocardial ischemia, were strongly associated with improved 30-day survival and better neurological outcomes following IHCA.
  • Identifying and addressing specific IHCA aetiologies can guide targeted interventions to enhance patient survival and recovery.
Abstract

Keywords:
AEDAetiologyCPRIHCA

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