Clinical outcomes of in-hospital cardiac arrest in a tertiary hospital and factors related to 28-day survival: A retrospective cohort study

OBJECTIVES: The primary aim was to define factors related to the return of spontaneous circulation (ROSC) after in-hospital cardiac arrest (IHCA), and the secondary aim was to determine factors related to 28-day mortality in patients admitted to intensive care unit (ICU) after ROSC.METHODS: In this retrospective study, we included the patients who suffered from IHCA in a tertiary hospital between July 2016 and April 2019. Pre- and post-resuscitation characteristics of the patients and event characteristics were defined to reveal the independent factors associated with ROSC and 28-day survival.RESULTS: A total of 254 patients (median age 73 years, 58.3% males) underwent cardiopulmonary resuscitation (CPR). The ROSC rate was 45.7%. Of all, 51 patients (median age, 63 years, 54.9% males) were admitted to in-hospital ICUs. The 28-day survival rate was 31.4%. The independent risk factors were chronic kidney disease (odds ratio [OR], 3.18, 95% confidence interval [CI], 1.37-7.19, P = 0.007), chronic obstructive pulmonary disease (OR, 2.84, 95% CI, 1.23-6.61, P = 0.015), asystole as an initial rhythm (OR, 2.94, 95% CI, 1.27-6.79, P = 0.012), multi-trauma-related complications (OR, 21.11, 95% CI, 4.71-94.69, P < 0.001), and septic shock (OR, 4.10; 95% CI, 1.16-14.54, P = 0.029) for ROSC; and a cerebral performance category score > 2 (OR, 20.86, 95% CI, 2.74-158.65, P = 0.003), Acute Physiology and Chronic Health Evaluation II score > 14 (OR, 7.58, 95% CI, 1.06-54.23, P = 0.044) for 28-day mortality.CONCLUSIONS: Independent risk factors related to ROSC and 28-day mortality were defined in the study. However, further studies are needed to devise new strategies for increased hospital discharge with preserved neurologic functions.