The Potential Risk Factors for Mortality in Patients After In-Hospital Cardiac Arrest: A Multicenter Study

Mei-Tzu Wang; Wei-Chun Huang; David Hung-Tsang Yen; En-Hui Yeh; Shih-Yuan Wu; Hsun-Hsiang Liao

doi:10.3389/fcvm.2021.630102

The Potential Risk Factors for Mortality in Patients After In-Hospital Cardiac Arrest: A Multicenter Study

Front Cardiovasc Med. 2021 Mar 16:8:630102. doi: 10.3389/fcvm.2021.630102. eCollection 2021.

Authors

Mei-Tzu Wang^{1

2}, Wei-Chun Huang^{1

3

4}, David Hung-Tsang Yen^{5

6}, En-Hui Yeh⁷, Shih-Yuan Wu⁷, Hsun-Hsiang Liao⁷

Affiliations

¹ Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
² Section of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
³ School of Medicine, National Yang-Ming University, Taipei, Taiwan.
⁴ Department of Physical Therapy, Fooyin University, Kaohsiung, Taiwan.
⁵ Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
⁶ Institute of Emergency and Critical Care Medicine, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
⁷ Joint Commission of Taiwan, New Taipei City, Taiwan.

Abstract

Background and Purpose: In-hospital cardiac arrest (IHCA) has high mortality rate, which needs more research. This multi-center study aims to evaluate potential risk factors for mortality in patients after IHCA. Methods: Data for this study retrospectively enrolled IHCA patients from 14 regional hospitals, two district hospitals, and five medical centers between 2013 June and 2018 December. The study enrolled 5,306 patients and there were 2,871 patients in subgroup of intensive care unit (ICU) and emergency room (ER), and 1,894 patients in subgroup of general wards. Results: As for overall IHCA patients, odds ratio (OR) for mortality was higher in older patients (OR = 1.69; 95% CI:1.33-2.14), those treated with ventilator (OR = 1.79; 95% CI:1.36-2.38) and vasoactive agents (OR = 1.88; 95% CI:1.45-2.46). Whereas, better survival was reported in IHCA patients with initial rhythm as ventricular tachycardia (OR = 0.32; 95% CI: 0.21-0.50) and ventricular fibrillation (OR = 0.26; 95% CI: 0.16-0.42). With regard to ICU and ER subgroup, there was no mortality difference among different nursing shifts, whereas for patients in general wards, overnight shift (OR = 1.83; 95% CI: 1.07-3.11) leads to poor outcome. Conclusion: For IHCA patients, old age, receiving ventilator support and vasoactive agents reported poor survival. Overnight shift had poor survival for IHCA patients in general wards, despite no significance in overall and ICU/ER subgroups.

Keywords: in-hospital cardiac arrest; intensive care unit; overnight shift; patient-to-nurse ratio; survival; targeted temperature management.