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Int J Cardiol. 2018 Mar 15;255:237-242. doi: 10.1016/j.ijcard.2017.12.068. Epub 2017 Dec 24.

Factors of importance to 30-day survival after in-hospital cardiac arrest in Sweden - A population-based register study of more than 18,000 cases.

Author information

1
Department of Anaesthesiology and Intensive Care Medicine, Hallands Hospital, Halmstad SE-301 85, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden. Electronic address: fredrik.hessulf@regionhalland.se.
2
Health metrics unit, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
3
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
4
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
5
School of Health and Social Sciences, University of Dalarna, Falun, Sweden.
6
Department of Research and Development, Västernorrland County Council, Sundsvall, Sweden.
7
Department of Clinical Science and Education at Södersjukhuset, Karolinska Institute, Stockholm, Sweden.
8
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Prehospen-Centre for Prehospital research, Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Sweden.
9
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Clinical Sciences, Karolinska Institute, Danderyds Hospital, 182088 Stockholm, Sweden.

Abstract

BACKGROUND AND OBJECTIVE:

In-hospital cardiac arrest (IHCA) constitutes a major contributor to cardiovascular mortality. The aim of the present study was to investigate factors of importance to 30-day survival after IHCA in Sweden.

METHODS:

A retrospective register study based on the Swedish Register of Cardiopulmonary Resuscitation (SRCPR) 2006-2015. Sixty-six of 73 hospitals in Sweden participated. The inclusion criterion was a confirmed cardiac arrest in which resuscitation was attempted among patients aged >18years.

RESULTS:

In all, 18,069 patients were included, 39% of whom were women. The median age was 75years. Thirty-day survival was 28.3%, 93% with a CPC score of 1-2. One-year survival was 25.0%. Overall IHCA incidence in Sweden was 1.7 per 1000 hospital admissions. Several factors were found to be associated with 30-day survival in a multivariable analysis. They included cardiac arrest (CA) at working days during the daytime (08-20) compared with weekends and night-time (20-08) (OR 1.51 95% CI 1.39-1.64), monitored CA (OR 2.18 95% CI 1.99-2.38), witnessed CA (OR 2.87 95% CI 2.48-3.32) and if the first recorded rhythm was ventricular fibrillation/tachycardia, especially in combination with myocardial ischemia/infarction as the assumed aetiology of the CA (OR for interaction 4.40 95% CI 3.54-5.46).

CONCLUSION:

30-day survival after IHCA is associated with the time of the event, the aetiology of the CA and the degree of monitoring and this should influence decisions regarding the appropriate level of monitoring and care.

KEYWORDS:

Epidemiology; In-hospital cardiac arrest; Survival

PMID:
29289346
DOI:
10.1016/j.ijcard.2017.12.068
[Indexed for MEDLINE]

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