Long-term survival comparison of patients admitted to the intensive care unit following in-hospital cardiac arrest in perioperative and ward settings. A multicentre retrospective cohort study

被引:1
|
作者
Ueno, Ryo [1 ,2 ,3 ]
Chan, Rachel [4 ]
Reddy, Mallikarjuna Ponnapa [5 ,6 ,7 ]
Jones, Daryl [2 ,3 ,8 ]
Pilcher, David [2 ,9 ,10 ]
Subramaniam, Ashwin [2 ,6 ,11 ,12 ]
机构
[1] Eastern Hlth, Box Hill Hosp, Dept Intens Care, Box Hill, Vic, Australia
[2] Monash Univ, Australian & New Zealand Intens Care Res Ctr, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia
[3] Austin Hlth, Dept Intens Care, Heidelberg, Vic, Australia
[4] Canberra Hosp, Dept Anaesthesia & Pain Med, Canberra, Australia
[5] Nepean Hosp, Dept Anaesthesia & Pain Med, Sydney, NSW, Australia
[6] Peninsula Hlth, Dept Intens Care, Frankston, Vic, Australia
[7] North Canberra Hosp, Dept Intens Care, Canberra, Australia
[8] Univ Melbourne, Parkville, Vic, Australia
[9] Australian & New Zealand Intens Care Soc, Ctr Outcome & Resource Evaluat, Melbourne, Vic, Australia
[10] Alfred Hosp, Dept Intens Care, Melbourne, Vic, Australia
[11] Dandenong Hosp, Dept Intens Care, Dandenong, Vic, Australia
[12] Monash Univ, Peninsula Clin Sch, Frankston, Vic, Australia
关键词
Long-term outcome; Intensive care medicine; Perioperative medicine; Cardiac arrest; EPIDEMIOLOGY; OUTCOMES; TRENDS;
D O I
10.1007/s00134-024-07570-w
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose Perioperative in-hospital cardiac arrests (Perioperative IHCAs) may have better outcomes than IHCAs in the ward (Ward IHCAs), due to enhanced monitoring and faster response. However, quantitative comparisons of their long-term outcomes are lacking, posing challenges for prognostication. Methods This retrospective multicentre study included adult intensive care unit (ICU) admissions from theatre/recovery or wards with a diagnosis of cardiac arrest between January 2018 and March 2022. We used data from 175 ICUs in the ANZICS adult patient database. The primary outcome was a survival time of up to 4 years. We used the Cox proportional hazards model adjusted for Sequential Organ Failure Assessment (SOFA) score, age, sex, comorbidities, hospital type, treatment limitation on admission to the ICU, and ICU treatments. Subgroup analyses examined age (>= 65 years), intubation within the first 24 h, elective vs. emergency admission, and survival on discharge. Results Of 702,675 ICU admissions, 5,659 IHCAs were included (Perioperative IHCA 38%; Ward IHCA 62%). Perioperative IHCA group were younger, less frail, and less comorbid. Perioperative IHCA were most frequent in patients admitted to ICU after cardiovascular, gastrointestinal, or trauma surgeries. Perioperative IHCA group had longer 4-year survival (59.9% vs. 33.0%, p < 0.001) than the Ward IHCA group, even after adjustments (adjusted hazard ratio [HR]: 0.63, 95% confidence interval [CI] 0.57-0.69). This was concordant across all subgroups. Of note, older patients with Perioperative IHCA survived longer than both younger and older patients with Ward IHCA. Conclusion Patients admitted to the ICU following Perioperative IHCA had longer survival than Ward IHCA. Future studies on IHCA should distinguish these patients.
引用
收藏
页码:1496 / 1505
页数:10
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