PURPOSE: To study the factors influencing survival amongst patients undergoing in-hospital cardiopulmonary resuscitation.
METHODS: We performed a retrospective chart review of all adult patients on whom a code-blue was called in our institution and analyzed demographic and clinical data.
RESULTS: Over a period of 3 years, 468 code-blue calls were made at our institution. 55 (11.7%) were classified as false codes as the patients were either DNR (Do Not Resuscitate) or they never lost their pulse. 76 (16.3%) were repeat codes within 24 hours of the primary event. There were a total of 337 primary events of in-hospital cardiopulmonary arrest. The average age of the patients was 70.34±15.09 years. 59.34% of the patients were male and 73.29% were Caucasian. 44% of the code blue calls were made at night and 22.89% were made during weekends. 23.15% of the primary events were un-witnessed and 9.5% of the events happened in non-monitored settings in the hospital. Only 21% of the patients had a shockable rhythm. Return of Spontaneous Circulation (ROSC) was achieved in 49.23% of the patients. The average time of resuscitation was 18.14±14.01 minutes and 47.3% of the patients underwent resuscitation for more than 15 minutes.
CONCLUSIONS: There was no statistical difference in mortality amongst patients undergoing in-hospital cardiopulmonary resuscitation based on sex, race, time of the day, time of the week (weekday versus weekend), the patient’s location in the hospital (monitored versus non-monitored bed) or the initial cardiac rhythm (shockable versus non-shockable). We also did not find a statistical difference in ROSC based on the duration of cardiopulmonary resuscitation.
CLINICAL IMPLICATIONS: The results of our study are consistent with medical literature on outcomes of in-hospital cardiopulmonary arrest. In-hospital cardiopulmonary arrest is very different than outpatient cardiopulmonary arrest, as the former patient population is much sicker. The rates of non-shockable rhythms are much higher in this population, and the initial ROSC and 24 hour mortality is dependent on the underlying co-morbidities and functional status rather than the acute instability of the patient.
DISCLOSURE: The following authors have nothing to disclose: Hardeep Rai, Vamsi Emani, Ankur Saini, Abhijit Duggal
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