Survival from Cardiac Arrest in the Accident and Emergency Department

Cope, A; Quinton, D N; Dove, A F; Sloan, John P.; Dave, S H

doi:10.1177/014107688708001207

Cited by 13 publications

(7 citation statements)

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“…Initial survival after CPR is up to 50 %, but there is low survival to hospital discharge, ranging from 11 to 37 % [ 1 ]. Considerable regional variation in the incidence and outcome of cardiac arrest within the United States has been reported [ 2 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, outcomes and factors associated with adult in hospital cardiac arrests in a low-income country tertiary hospital: a prospective observational study

et al. 2015

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BackgroundResearch on cardiac arrest and cardiopulmonary resuscitation (CPR) has considerably increased in recent decades, and international guidelines for resuscitation have been implemented and have undergone several changes. Very little is known about the prevalence and management of in-hospital cardiac arrest in low-resource settings. We therefore sought to determine the prevalence, outcomes and associated factors of adult inpatients with cardiac arrest at a tertiary referral hospital in a low-income country.MethodsUpon obtaining institutional approval, we conducted a prospective observational period prevalence study over a 2-month period. We recruited adult inpatients with cardiac arrest in the intensive care unit and emergency wards of Mulago Hospital, Uganda during the study period. We reviewed all files and monitoring charts, and also any postmortem findings. Data were analyzed with Stata 12 and statistical significance was set at p < 0.05.ResultsThere was a cardiac arrest in 2.3 % (190) of 8,131 hospital admissions; 34.5 % occurred in the intensive care unit, 4.4 % in emergency operating theaters, and 3.0 % in emergency wards. A majority (63.2 %) was unwitnessed, and only 35 patients (18.4 %) received CPR. There was return of spontaneous circulation (ROSC) in 14 (7.4 %) cardiac arrest patients. Survival to 24 h occurred in three ROSC patients, which was only 1.6 % of all cardiac arrest patients during the study period. Trauma was the most common primary diagnosis and HIV infection was the most common co-morbidity.ConclusionOur hospital has a high prevalence of cardiac arrest, and low rates of CPR performance, ROSC, and 24-hour survival. Single provider CPR; abnormal temperatures as well as after hours/weekend CAs were associated with lower survival rates.

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Section: Introductionmentioning

confidence: 99%

Prevalence, outcomes and factors associated with adult in hospital cardiac arrests in a low-income country tertiary hospital: a prospective observational study

et al. 2015

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“…The overall unadjusted survival to hospital discharge rate was 18.4% 1,2 . Outcome data for cardiac arrests in the A&E department is not available except in one study done in 1987 3. The outcome after a cardiac arrest and cardiopulmonary resuscitation (CPR) depends on several factors such as patient-related and resuscitation-related factors, critical intervention (particularly early defibrillation depending on initial cardiac rhythm), and CPR of good quality with effective uninterrupted chest compressions and assisted ventilation 1,3 . Despite considerable efforts to improve the treatment of cardiac arrest, most of the reported survival outcome data is poor.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Arrests and Outcomes at Accident and Emergency (A&E) Department in a Tertiary Care Hospital of Sri Lanka

Jayasekera

Dasanayake²,

Bandara³

et al. 2022

Sri Lankan J Anaesthesiol

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Background: Witnessed cardiac arrest is a common occurrence in an A&E department. The reported incidence of witnessed cardiac arrest is variable around the world. Overall unadjusted survival to hospital discharge rate was 18.4%. Objective: To assess the aetiology, factors associated in outcomes of witnessed cardiac arrests, and the rate of occurrence of cardiac arrest at the A&E of Provincial General Hospital Kurunegala (PGHK). Methods: This descriptive study was conducted between January1, 2016, to December 31, 2016 (one year) at the A&E department of PGHK. Survivors were followed up on for a one-year period. Results: There were 123 witnessed cardiac arrests (mean age 64 (+/-15.9) years, 64% male), out of which 25 patients were successfully resuscitated {return of spontaneous circulation (ROSC)} and transferred to intensive care units for further care. However, only 6 (4.9%) patients were discharged from the hospital. The three-month and one-year survival numbers were 6 (4.9%) (males: 4, females: 2) and 4 (3.3%) (males: 3, female: 1) respectively. The age of the female survivor after one year was 43 years and the ages of the three male survivors were 46, 54, and 55 years respectively. The most common aetiology for cardiac arrest was myocardial infarction (43.1%) while the most common initial rhythm was non-shockable (82%). The initial rhythm was shockable in all 6 survivors. Conclusion: The overall ratio of survival to discharge was much lower in comparison to international figures. The poor survival rate in our study may be due a very high rate of cardiac arrests with initial non-shockable rhythms.

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“…The overall unadjusted survival to hospital discharge rate was 18.4% 3 [1,2]. Outcome data for cardiac arrests in the A&E department is not available except in one study done in 1987 [3]. The outcome after a cardiac arrest and cardiopulmonary resuscitation (CPR) depends on several factors such as patient-related and resuscitation-related factors, critical intervention (particularly early defibrillation depending on initial cardiac rhythm), and delivery of good quality CPR with effective uninterrupted chest compressions and assisted ventilation [1,3].…”

Section: Introductionmentioning

confidence: 99%

“…Cardiac arrest is the cessation of mechanical cardiac activity as confirmed by the absence of signs of circulation. A witnessed cardiac arrest is one that is seen or heard by another person or an arrest that is monitored [3]. CPR is an attempt to restore spontaneous circulation by performing chest compressions with or without ventilation.…”

Section: Introductionmentioning

confidence: 99%

Cardiac Arrests and Outcomes at Accident and Emergency (A&E) Department in A Tertiary Care Hospital of Sri Lanka.

Jayasekera

Dassanayake²,

Bandara³

et al. 2020

Preprint

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Background : Witnessed cardiac arrest is a common occurrence in an A&E department. The reported incidence of witnessed cardiac arrest is variable around the world. The overall unadjusted survival to hospital discharge rate was18.4% at the time of performing this study [1]. Methods: This descriptive study was conducted between January 1, 2016 to December 31, 2016 ( one year) at the A&E department of Provincial General Hospital Kurunegala. The objective was to assess the aetiology, factors associated in outcomes of witnessed cardiac arrests, and the rate of occurrence of cardiac arrest at the A&E of Provincial General Hospital Kurunegala (PGHK). Survivors were followed up on for a one-year period following the study’s conclusion. Results: There were 123 witnessed cardiac arrests (mean age 64 (+/- 15.9) years, 64% male), out of which 25 patients were successfully resuscitated and transferred to intensive care units for further care. However, only 6 (4.9%) patients were discharged from the hospital. The three-month and one-year survival numbers were 6 (4.9%) (males: 4, females: 2) and 4 (3.3%) (males: 3, female: 1) respectively. The age of the sole female survivor after one year was 43 years and the ages of the three male survivors were 46, 54, and 55 years respectively. The most common aetiology for cardiac arrest was myocardial infarction (43.1%) while the most common initial rhythm was non-shockable (82%). The initial rhythm was shockable in all 6 survivors. Conclusion: The overall ratio of survival to discharge in this study was much lower in comparison to international figures. The poor survival rate in this study may be due a very high rate of cardiac arrests with initial non-shockable rhythms in this study’s population.

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Survival from Cardiac Arrest in the Accident and Emergency Department

Cited by 13 publications

References 10 publications

Prevalence, outcomes and factors associated with adult in hospital cardiac arrests in a low-income country tertiary hospital: a prospective observational study

Prevalence, outcomes and factors associated with adult in hospital cardiac arrests in a low-income country tertiary hospital: a prospective observational study

Cardiac Arrests and Outcomes at Accident and Emergency (A&E) Department in a Tertiary Care Hospital of Sri Lanka

Cardiac Arrests and Outcomes at Accident and Emergency (A&E) Department in A Tertiary Care Hospital of Sri Lanka.

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Survival from Cardiac Arrest in the Accident and Emergency Department

Cited by 13 publications

References 10 publications

Prevalence, outcomes and factors associated with adult in hospital cardiac arrests in a low-income country tertiary hospital: a prospective observational study

Prevalence, outcomes and factors associated with adult in hospital cardiac arrests in a low-income country tertiary hospital: a prospective observational study

Cardiac Arrests and Outcomes at Accident and Emergency (A&E) Department in a Tertiary Care Hospital of Sri Lanka

Cardiac Arrests and Outcomes at Accident and Emergency (A&amp;E) Department in A Tertiary Care Hospital of Sri Lanka.

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Cardiac Arrests and Outcomes at Accident and Emergency (A&E) Department in A Tertiary Care Hospital of Sri Lanka.