Epidemiology of in-hospital cardiac arrest in Abu Dhabi, United Arab Emirates, 2013–2015

Abstract

ObjectiveEstimate the incidence and outcomes of in-hospital cardiac arrest (IHCA) in a tertiary-care hospital in Abu Dhabi emirate, United Arab Emirates (UAE).MethodsRetrospective data from 685 inpatients who experienced an IHCA at a hospital in Abu Dhabi (UAE) between 1 January 2013 and 31 December 2015 were analysed. Sociodemographic variables were age and gender, and IHCA event variables were shift, day, event location, initial cardiac rhythm and the total number of IHCA events. Outcome variables were the return of spontaneous circulation (ROSC) and survival to discharge (StD).ResultsThe incidence of IHCA was 11.7 (95% CI 10.8 to 12.6) per 1000 hospital admissions. Non-shockable rhythms were 91.1% of the cardiac rhythms at presentation. The majority of IHCA cases occurred in the intensive care unit (46.1%) and on weekdays (74.6%). More than a third (38.3%) of patients who experienced an IHCA achieved ROSC and 7.7% StD. Both ROSC and StD were significantly higher in patients who were younger and presenting with a shockable rhythm (all p’s≤0.05). Survival outcomes were not significantly different between dayshifts and nightshifts or weekdays and weekends.ConclusionsThe incidence of IHCA was higher and its outcomes were lower compared with other high-income/developed countries. Survival outcomes were better for patients who were younger and had a shockable rhythm, and similar between time of day and days of the week. These findings may help to inform health managers about the magnitude and quality of IHCA care in the UAE.

Prevalence and outcomes of sudden cardiac arrest in a university hospital in the Western Region, Saudi Arabia

“…This rate is considerably higher than that found among patients with IHCA in single-centre studies from Taiwan (40%)[28] and UAE (38.7%). [10] An important factor that may have caused this variation is the differences in the location of SCA among the three studies. For example, 49% and 46% of the SCA in the latter studies occurred in the ICU,[1028] whereas it was only 37.3% in the current study.…”

“…[10] An important factor that may have caused this variation is the differences in the location of SCA among the three studies. For example, 49% and 46% of the SCA in the latter studies occurred in the ICU,[1028] whereas it was only 37.3% in the current study. This further emphasizes our results regarding poor prognosis of SCA in the ICU.…”

“…The IHCA survival-to-discharge rate has been reported to be between 20% and 30%, with some outliers. [89101112] Two regional studies in the Saudi Arabia and United Arab Emirates have found that the return of spontaneous circulation (ROSC) was 64% and 38%, while the survival rate at discharge was 30% and 8%, respectively. [910] This indicates that survival rates vary across regions, depending on several key predictors such as setting of the arrest, bystander cardiopulmonary resuscitation (CPR), postresuscitation care, time of initiating basic life support and prompt defibrillation.…”

“…[89101112] Two regional studies in the Saudi Arabia and United Arab Emirates have found that the return of spontaneous circulation (ROSC) was 64% and 38%, while the survival rate at discharge was 30% and 8%, respectively. [910] This indicates that survival rates vary across regions, depending on several key predictors such as setting of the arrest, bystander cardiopulmonary resuscitation (CPR), postresuscitation care, time of initiating basic life support and prompt defibrillation. [131415] Studies from the Unites States and Thailand have found that patients with IHCA on whom CPR was properly performed have better outcomes compared with OHCA patients.…”

“…Monitoring key predictors of survival such as ventricular fibrillation and ventricular tachycardia are important as they have been found to impact survival rates; however, they are often not monitored, especially in IHCA patients. [910171819202122232425] In addition, epidemiological knowledge of key outcomes for SCA can likely improve overall survival rates; however, there is limited such data available from Saudi Arabia. Therefore, the current study aimed to investigate the prevalence, circumstances and outcomes of patients with SCA who were resuscitated at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia.…”