Eltarras Ahmed, Jalloul Youssef, Assaad Ola, Bejjani Michael, Yammine Yara, Khatib Nina, Rebeiz Abdallah, Sayed Mazen El, Refaat Marwan
Geriatric Medicine Division, Saint Louis University School of Medicine, Missouri, USA.
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
J Geriatr Cardiol. 2021 Jun 28;18(6):416-425. doi: 10.11909/j.issn.1671-5411.2021.06.005.
In-hospital cardiac arrest (IHCA) constitutes a significant cause of morbidity and mortality. As data is scarce in the Middle East and Lebanon, we devised this study to shed some light on it to better inform both hospitals and policymakers about the magnitude and quality of IHCA care in Lebanon.
We analyzed retrospective data from 680 IHCA events at the American University of Beirut Medical Center between July 1, 2016 and May 2, 2019. Sociodemographic variables included age and sex, in addition to the comorbidities listed in the Charlson comorbidity index. IHCA event variables were day, event location, time from activation to arrival, initial cardiac rhythm, and the total number of IHCA events. We also looked at the months and years. We considered the return of spontaneous circulation (ROSC) and survival to discharge (StD) to be our outcomes of interest.
The incidence of IHCA was 6.58 per 1,000 hospital admissions (95% CI: 6.09-7.08). Non-shockable rhythms were 90.7% of IHCAs. Most IHCA cases occurred in the closed units (87.9%) (intensive care unit, respiratory care unit, neurology care unit, and cardiology care unit) and on weekdays (76.5%). ROSC followed more than half the IHCA events (56%). However, only 5.4% of IHCA events achieved StD. Both ROSC and StD were higher in cases with a shockable rhythm. Survival outcomes were not significantly different between day, evening, and nightshifts. ROSC was not significantly different between weekdays and weekends; however, StD was higher in events that happened during weekdays than weekends (6.7%. 1.9%, = 0.002).
The incidence of IHCA was high, and its outcomes were lower compared to other developed countries. Survival outcomes were better for patients who had a shockable rhythm and were similar between the time of day and days of the week. These findings may help inform hospitals and policymakers about the magnitude and quality of IHCA care in Lebanon.
院内心脏骤停（IHCA）是发病和死亡的重要原因。由于中东和黎巴嫩的数据稀缺，我们开展了这项研究，以阐明相关情况，从而更好地让医院和政策制定者了解黎巴嫩IHCA护理的规模和质量。
我们分析了2016年7月1日至2019年5月2日期间贝鲁特美国大学医疗中心680例IHCA事件的回顾性数据。社会人口统计学变量包括年龄和性别，以及Charlson合并症指数中列出的合并症。IHCA事件变量包括日期、事件发生地点、从启动到到达的时间、初始心律以及IHCA事件总数。我们还查看了月份和年份。我们将自主循环恢复（ROSC）和出院存活（StD）视为我们感兴趣的结果。
IHCA的发生率为每1000例住院患者6.58例（95%置信区间：6.09 - 7.08）。不可电击心律占IHCA的90.7%。大多数IHCA病例发生在封闭病房（占87.9%）（重症监护病房、呼吸护理病房、神经科护理病房和心脏病护理病房）和平日（占76.5%）。超过一半的IHCA事件（56%）出现了ROSC。然而，只有5.4%的IHCA事件实现了StD。可电击心律的病例中ROSC和StD都更高。白天、傍晚和夜班的存活结果无显著差异。工作日和周末之间ROSC无显著差异；然而，工作日发生的事件的StD高于周末（6.7%对1.9%，P = 0.002）。
与其他发达国家相比，黎巴嫩IHCA的发生率较高，但其结果较差。可电击心律的患者存活结果较好，且在一天中的不同时间和一周中的不同日子之间相似。这些发现可能有助于让医院和政策制定者了解黎巴嫩IHCA护理的规模和质量。
