PURPOSE: Cardiac arrest is common among hospitalized patients, yet controversy persists on the predictors and benefits of successful resuscitation. Older studies reported discharge survival of 4% to 24%, but included patients different from the uninsured minority populations served by many urban public hospitals. Our goal was to describe the prevalence and predictors of surviving in-hospital cardiopulmonary arrest at a large public hospital in Chicago. Because resources are more scarce at public hospitals, we predicted that successful resuscitation and survival would be worse than rates reported for insured populations.
METHODS: We retrospectively abstracted the resuscitation records of all 112 adult inpatients who arrested during 2004 using a standardized data collection form. Only the initial arrest was included while arrests in the emergency room were excluded. We used the hospital’s electronic medical records system to obtain survival data.
RESULTS: The mean (SD) age was 54 (14) years. Most arrests (75%) occurred in an intensive care unit. The most common initial rhythms were asystole 20%, PEA 20%, and bradyarrhythmia 14%. Survival at day(s) 1, 7, and at discharge were 41%, 30%, and 23% respectively. No patient with a return of pulse after 10 minutes survived. The two strongest predictors of survival to discharge were location of arrest (ICU 10% vs. ward 39%, P=0.008, Fisher’s exact) and time of arrest (day/evening shift 24% vs. night shift 0%,P=0.06, Fisher’s exact).
CONCLUSION: Patients suffering cardiopulmonary arrest in our urban public hospital were much younger than reported in previous studies, and survival rates are higher. However, no patient survived who arrested on the night shift or who underwent resuscitation for more than 10 minutes before a pulse was restored.
CLINICAL IMPLICATIONS: More research is needed to identify the predisposing factors for arrest in this young disadvantaged population.
DISCLOSURE: Sucharita Kamdar, None.