Associated factors with the occurrence of in-hospital cardiac arrest in patients admitted to internal medicine wards for non-cardiovascular causes

Raimundo Carmona-Puerta; José Luis Choque-Laura; Elibet Chávez-González; Joel Peñaló-Batista; Marielys Del Carmen Martínez-Sánchez; Elizabeth Lorenzo-Martínez

doi:10.1016/j.medcli.2024.01.014

Associated factors with the occurrence of in-hospital cardiac arrest in patients admitted to internal medicine wards for non-cardiovascular causes

Med Clin (Barc). 2024 Apr 17:S0025-7753(24)00131-3. doi: 10.1016/j.medcli.2024.01.014. Online ahead of print.

[Article in English, Spanish]

Authors

Raimundo Carmona-Puerta¹, José Luis Choque-Laura², Elibet Chávez-González³, Joel Peñaló-Batista⁴, Marielys Del Carmen Martínez-Sánchez⁵, Elizabeth Lorenzo-Martínez⁵

Affiliations

¹ Universidad Católica del Cibao, La Vega, República Dominicana. Electronic address: endotelio1975@gmail.com.
² Servicio de Medicina Interna, Hospital Municipal Boliviano Holandés, Provincia Murillo, El Alto, Bolivia.
³ Servicio de Arritmología y Electrofisiología, Hospital Universitario Cardiocentro Ernesto Guevara, Santa Clara, Cuba.
⁴ Universidad Católica del Cibao (UCATECI), Centro de Medicina Familiar Especializada (CEMEFE), La Vega, República Dominicana.
⁵ Escuela de Medicina, Universidad Católica del Cibao, La Vega, República Dominicana.

PMID: 38637218
DOI: 10.1016/j.medcli.2024.01.014

Abstract

Background and objective: In-hospital cardiac arrest (IHCA) has a low survival rate, so it is essential to recognize the cases with the highest probability of developing it. The aim of this study is to identify factors associated with the occurrence of IHCA.

Material and methods: A single-center case-control study was conducted including 65 patients admitted to internal medicine wards for non-cardiovascular causes who experienced IHCA, matched with 210 admitted controls who did not present with IHCA.

Results: The main reason for admission was pneumonia. The most prevalent comorbidity was arterial hypertension. Four characteristics were strongly and independently associated with IHCA presentation, these are electrical left ventricular hypertrophy (LVH) (OR: 13.8; 95% IC: 4.7-40.7), atrial fibrillation (OR: 9.4: 95% CI: 4.3-20.6), the use of drugs with known risk of torsades de pointes (OR: 2.7; 95% CI: 1.3-5.5) and the combination of the categories known risk plus conditional risk (OR: 17.1; 95% CI: 6.7-50.1). The first two detected in the electrocardiogram taken at the time of admission.

Conclusion: In admitted patients for non-cardiovascular causes, the use of drugs with a known risk of torsades de pointes, as well as the detection of electrical LVH and atrial fibrillation in the initial electrocardiogram, is independently associated with a higher probability of suffering a IHCA.

Keywords: Atrial fibrillation; Fibrilación auricular; Hipertrofia ventricular izquierda; In-hospital cardiac arrest; Left ventricular hypertrophy; Paro cardiaco intrahospitalario; Predictores; Predictors; Torsades de pointes.