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Education, Research, and Quality Improvement |

Two-Year Retrospective Analysis of Cardiac Arrest Outcomes at a County Hospital

Monay Mahmoud*, MD; Syed Imam, MD; Hetalben Patel, MD; Todd Rice, MD; Matthew King, MD; Richard Fremont, MD
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Meharry Medical College, Nashville, TN


Chest. 2012;142(4_MeetingAbstracts):549A. doi:10.1378/chest.1384770
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Abstract

SESSION TYPE: Outcomes/Quality Control Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Cardiopulmonary resuscitation is the standard practice for patients who suffer sudden cardiac arrests in and out of hospitals. We reviewed all cardiac and respiratory arrests at Nashville General Hospital, a small county hospital, during a 2 year period (2010-2011). The study looks for factors that may have influenced survival outcomes.

METHODS: A retrospective chart review was performed for all patients who had cardiac or respiratory arrests between January 2010 and December 2011. Patient characteristics were reviewed with a primary outcome of survival to discharge. All information was obtained via review of “code sheets,” progress notes, and chart review. We evaluated reasons for admission, baseline characteristics and features of the arrest and post arrest care, including: location, timing and duration of codes.

RESULTS: Fifty-nine patients suffered cardiac or respiratory arrest during the study period. There were 98 codes called for these 59 patients as 18 (30%) had multiple arrests. Thirty-six patients survived the first arrest but only 10 (16%) patients survived to discharge. Pulseless electrical activity/asystole was the most common documented rhythm of all codes (55%). Statistically significant factors for survival to discharge included: younger age (p < 0.001), and patients who had more than one code versus a single code (p = 0.026). No other factors were found to be significant including: sex, race, primary diagnosis, smoking, time of day, duration or type of code. ACLS was followed in 98% of the codes with only minor deviations from protocol.

CONCLUSIONS: Patients who undergo an in-hospital cardiac arrest are very unlikely to survive until discharge. We found that the only factors that influenced survival to discharge were patients being younger, and undergoing multiple codes. Interestingly, the length or type of code did not influence outcomes in our population.

CLINICAL IMPLICATIONS: Positive outcomes for cardiac arrests in our hospital were influenced by the age of the patient and how many times they arrested. We found that only 16% of patients who had an arrest survived to discharge.

DISCLOSURE: The following authors have nothing to disclose: Monay Mahmoud, Syed Imam, Hetalben Patel, Todd Rice, Matthew King, Richard Fremont

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Meharry Medical College, Nashville, TN

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