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Management and prevention of in-hospital cardiac arrest: present and future

Jonathan Vo1, Faye L Norby2, Paul Marano1

  • 1Center for Cardiac Arrest Prevention, Department of Cardiology, Smidt Heart Institute. Cedars-Sinai Health System, Los Angeles, CA, USA.

NPJ Cardiovascular Health
|March 3, 2026
PubMed

Insights

In-hospital cardiac arrest (IHCA) research is significantly less explored than out-of-hospital cardiac arrest (OHCA). This review highlights IHCA knowledge gaps and future research opportunities for improved patient outcomes.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Clinical Research

Background:

  • Cardiac arrest, defined as cessation of cardiac mechanical activity, is categorized into in-hospital (IHCA) and out-of-hospital (OHCA) events.
  • IHCA and OHCA differ in epidemiology, natural history, comorbidities, care processes, and provider characteristics, necessitating distinct research approaches.
  • Existing research, including over 150 randomized controlled trials (RCTs) from 1995-2019, predominantly focuses on OHCA (>80%), with IHCA receiving less than 10% of investigative attention.

Purpose of the Study:

  • To provide a comprehensive overview of the current knowledge regarding IHCA epidemiology, management, and prevention strategies.
  • To identify critical research gaps and opportunities for future investigations specifically within IHCA.

Main Methods:

  • Review of existing literature and randomized controlled trials (RCTs) focusing on cardiac arrest research between 1995 and 2019.
  • Analysis of the distribution of research focus between IHCA and OHCA.
  • Synthesis of current knowledge on IHCA epidemiology, management, and prevention.

Main Results:

  • The vast majority of cardiac arrest RCTs (>80%) between 1995 and 2019 concentrated on OHCA.
  • A significantly smaller proportion of studies (<10%) focused exclusively on IHCA.
  • IHCA has received disproportionately less investigative attention compared to OHCA.

Conclusions:

  • There is a substantial disparity in research focus between IHCA and OHCA, with IHCA being under-investigated.
  • Further research into IHCA epidemiology, management, and prevention is crucial to improve patient outcomes.
  • Identifying and addressing research gaps in IHCA is essential for advancing the field of cardiac arrest care.

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