[Prognostic factors of mortality in a cohort of patients with in-hospital cardiorespiratory arrest]

Abstract

Objective: To define the prognostic factors related with mortality of patients who suffer cardiorespiratory arrest (CRA) in the hospital, according to Utstein style guidelines.

Design: A descriptive and prospective study covering a 30-month consecutive period of all the patients who suffered at least one episode of in-hospital CRA. A Cox regression multivariate analysis was made to identify the independent factors associated with mortality.

Setting: A medical-surgical center in Hospital "Virgen de las Nieves" (HUVN), Granada (Spain).

Patients: All the patients attended due to CRA in the hospital, except for those occurring in the operating and recovery room areas. They were followed-up to hospital discharge.

Main variables: Mortality on hospital discharge.

Results: 203 patients who suffered at least one cardiorespiratory arrest in the hospital, with a median age of 67 years and preponderance of male (60.6%). The most common location was in intensive care medicine unit (48%) and cardiac etiology (62%). Hospital survival rate was 23.15%. In multivariate analysis, strong predictors of mortality were administration of any dose of epinephrine during resuscitation maneuvers (OR 3.4; CI 95%. 1.6-7), total duration of resuscitation (HR 1.018; CI 95%, 1.012-1.024) and as protective factors the first ventricular fibrillation/ventricular tachycardia rhythm with no pulse (HR 0.6; CI 95%, 0.4-0.9) and witnessed by a doctor (HR 0.6; CI 95%, 0.5-0.9).

Conclusions: The type of witness was identified among the predictors of mortality on hospital discharge after an episode of cardiac arrest. This becomes important because the qualification of healthcare personnel can be improved through adequate training.