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ACLS Protocol and Mortality in a Tertiary Care University Hospital FREE TO VIEW

Patton Thompson*, MD; Timothy Wiemken, PhD; Rodrigo Cavallazzi, MD; Mohamed Saad, MD; Michael Scott, MD; Sajjad Jameel, MD
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University of Louisville, Louisville, KY

Chest. 2012;142(4_MeetingAbstracts):550A. doi:10.1378/chest.1387126
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SESSION TYPE: Outcomes/Quality Control Posters

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

PURPOSE: Following Advanced Cardiovascular Life Support (ACLS) protocols have clearly been demonstrated to improve return of spontaneous circulation (ROSC) in the setting of cardiac arrest; however in reality it is often the case that codes are not ran perfectly according to the ACLS protocol. In a busy, urban, tertiary care university hospital we sought to determine whether ACLS protocol was followed correctly for in hospital cardiac arrests, and if that resulted in a difference in post-code mortality.

METHODS: From January 2009 to June 2011 268 in hospital cardiac arrests occurred. During each code data was collected in real time and afterwards a committee determined whether ACLS protocol was followed according to the latest guidelines. The primary end point was mortality.

RESULTS: There were 84 deaths and 165 successful resuscitations, 19 observations were deleted secondary to insufficient data. Using an unadjusted logistic regression model, patients who died had a 60% decreased odds of having had ACLS protocol correctly followed, Odds ratio 0.408 (95% CI 0.212 - .787, p = .0075). Those that died had 75% higher odds of having been admitted to the ICU at the time of cardiac arrest, Odds ratio 1.74 (95% CI .942 - 3.217, p = .0072).

CONCLUSIONS: Correctly following ACLS protocol improves post-code mortality. Patients who have cardiac arrest in the ICU have higher mortality regardless of correct performance of ACLS protocol.

CLINICAL IMPLICATIONS: Our study suggests that Institutions should make every effort to ensure ACLS protocol compliance to improve ROSC and post-code mortality. Most likely patients who are not critically ill at baseline (admitted to an area outside the ICU) would benefit the most from correct performance of ACLS protocol for in hospital cardiac arrests.

DISCLOSURE: The following authors have nothing to disclose: Patton Thompson, Timothy Wiemken, Rodrigo Cavallazzi, Mohamed Saad, Michael Scott, Sajjad Jameel

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University of Louisville, Louisville, KY




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