Analysis of Clinical Characteristics and Resuscitation Outcomes of Adult Patients with In-hospital Cardiac Arrest

Abstract

Objective To analyze the clinical features and resuscitation outcome of adult patients with cardiac arrest (CA) in intensive care unit, and discuss the related factors affecting the success rate of cardiopulmonary resuscitation in adult patients with CA. Methods The clinical data of CA patients in the intensive care unit of the First Hospital of Jilin University from September 2019 to December 2020 were retrospectively analyzed. According to the outcome indicators, the patients were divided into return of spontaneous circulation (ROSC) group and non-ROSC group, survival-discharge group and death group. The relevant factors affecting resuscitation outcome were discussed. Results A total of 351 patients with CA were included in this study, including 206 males and 145 females; the median age was 63 years. There were 191 patients with cardiogenic CA and 267 patients with non-defibrillation rhythm (cardiac arrest and no electrical activity) at the onset of CA. After treatment with CPR, 152 patients had ROSC, of whom 42 survived and were discharged. Univariate Logistic regression analysis showed that coronary artery disease, non-defibrillation rhythm, no defibrillation rhythm during resuscitation, no electric defibrillation, and no emergency endotracheal intubation were the possible factors that reduced the incidence of ROSC. Young age, CPR duration ≤30 min, and small cumulative dose of epinephrine were the possible factors that increased the incidence of ROSC. Non-cardiogenic etiology, non-defibrillable rhythm, no electric defibrillation, and no defibrillable rhythm during resuscitation decreased the likelihood of survival and discharge, whereas CPR duration ≤30 min and a small cumulative dose of epinephrine increased the likelihood of survival and discharge. Multivariate Logistic regression analysis showed that CPR duration > 30 min was an independent risk factor for ROSC, and young age, emergency tracheal intubation, and small cumulative epinephrine dose were independent protective factors for ROSC. CPR duration > 30 min was an independent risk factor for survival and discharge, and cardiogenic etiology and presence of defibrillable rhythm during resuscitation were independent protective factors for survival and discharge. Conclusions CPR duration, cumulative epinephrine dose, CA initial rhythm, electric defibrillation, and emergence of defibrillable rhythm during resuscitation are associated factors for ROSC as well as survival and discharge, and CPR duration > 30 min is an independent risk factor. Clinical attention should be paid to these factors in order to improve the outcome of cardiopulmonary resuscitation.

Keywords

• cardiac arrest
• cardiopulmonary resuscitation
• return of spontaneous circulation