Who survives cardiac arrest in the intensive care units?

J Crit Care. 2009 Sep;24(3):408-14. doi: 10.1016/j.jcrc.2008.10.006.

Abstract

Objective: The aim of this study was to evaluate the factors related to outcome regarding in-intensive care unit (ICU) cardiac arrest (IICA) in a university hospital.

Patients and methods: Adult nontraumatic ICU patients who sustained IICA were prospectively enrolled. Several patient and event-related variables, as well as outcomes, were recorded and summarized based on the revised Utstein-style template.

Results: A total of 202 episodes of IICA happened during the study period. Return of spontaneous circulation (ROSC) was achieved in 127 patients (62.9%), whereas the overall survival-to-discharge rate was 15.3% (31 patients). In univariate analysis, a shorter duration of resuscitation and pulseless ventricular tachycardia/ventricular fibrillation (VT/VF) as initial arrest rhythm represented better outcomes. Independent predictors of survival to hospital discharge were VT/VF as the initial rhythm (odds ratio [OR], 3.81; 95% confidence interval [CI], 1.50-9.67; P = .005), lower Acute Physiology and Chronic Health Evaluation II score (OR 0.92, 95% CI 0.87-0.98, P = .008), and shorter resuscitation durations (OR 0.91, 95% CI 0.87-0.96, P < .001).

Conclusion: Shorter resuscitation duration and initial VT/VF are predictors for both ROSC and hospital survival, whereas lower Acute Physiology and Chronic Health Evaluation II scores predict the latter.

MeSH terms

  • APACHE
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Female
  • Heart Arrest / mortality*
  • Hospital Mortality*
  • Hospitals, University
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Male
  • Middle Aged
  • Sex Factors
  • Tachycardia, Ventricular / mortality
  • Time Factors
  • Ventricular Fibrillation / mortality