doiSerbia

Outcome among patients suffering from in-hospital cardiac arrest

Trpković Sladjana (Surgical Clinic, School of Medicine, Kosovska Mitrovica)
Pavlović Aleksandar (Surgical Clinic, School of Medicine, Kosovska Mitrovica)
Bumbaširević Vesna (Center of Anesthesiology and Resuscitation, Clinical Center of Serbia, Belgrade + Faculty of Medicine, Belgrade)
Sekulić Ana (Clinical Hospital Center “Bežanijska kosa”, Belgrade)
Miličić Biljana (Center of Anesthesiology and Resuscitation, Clinical Center of Serbia, Belgrade + School of Dental Medicine, Belgrade)

Introduction. In relation to pre-hospital treatment of patients with cardiac arrest (CA) in the field where resuscitation is often started by nonprofessionals, resuscitation in hospital is most commonly performed by well-trained personnel. Objective. The aim was to define the factors associated with an improved outcome among patients suffering from the inhospital CA (IHCA). Methods. The prospective study included a total of 100 patients in the Emergency Center over two-year period. The patterns by the Utstein-Style guidelines recorded the following: age, sex, reason for hospital admission, comorbidity, cause and origin of CA, continuous monitoring, time of arrival of the medical emergency team and time of delivery of the first defibrillation shock (DC). Results. Most patients (61%) had cardiac etiology. Return of spontaneous circulation (ROSC) was achieved in 58% of patients. ROSC was more frequently achieved in younger patients (57.69±11.37), (p<0.05), non-surgical patients (76.1%), (p<0.01) and in patients who were in continuous monitoring (66.7%) (p<0.05). The outcome of CPR was significantly better in patients who received advanced life support (ALS) (76.6%) (p<0.01). Time until the delivery of the first DC shock was significantly shorter in patients who achieved ROSC (1.67±1.13 min), (p<0.01). A total of 5% of IHCA patients survived to hospital discharge. Conclusion. In our study, the outcome of CPR was better in patients who were younger and with non-surgical diseases, which are prognostic factors that we cannot control. Factors associated with better outcome of IHCA patients were: continuous monitoring, shorter time until the delivery of the first DC and ALS. This means that better education of medical staff, better organization and up-to-dated technical equipment are needed.

Keywords: in-hospital cardiac arrest, cardiopulmonary resuscitation, basic life support, advanced life support