Ahmed Faiza, Abbasi Lubna, Ghouri Nida, Patel Muhammad Junaid
Dr. Faiza Ahmed, (FCPS II Trainee Year 4, Internal Medicine), Training R4 Internal Medicine, Department of Internal Medicine, Indus Hospital and Health Network Karachi, Pakistan.
Dr. Lubna Abbasi, FCPS. Internal Medicine/Rheumatology, Department of Internal Medicine, Indus Hospital and Health Network Karachi, Pakistan.
Pak J Med Sci. 2022 Jan;38(2):387-392. doi: 10.12669/pjms.38.ICON-2022.5776.
To determine epidemiology of in-hospital cardiac arrest (IHCA) in a tertiary care hospital, pre- and during pandemic.
This is a cross-sectional study of inpatients who experienced an in-hospital-cardiac arrest at a tertiary care hospital in Karachi between August 2019 and August 2020. Outcome variables were return of spontaneous circulation (ROSC) and survival to discharge (StD) and analysis was also done comparing pre- and during pandemic period.
A total of 77 patients experienced at least one IHCA event during the 1-year study period. Comparing pre- and during pandemic, ROSC for women was higher during the pandemic albeit not significant (43% vs 50%) in comparison to men (54% vs 10%, p<0.001). During the pandemic, women with IHCA were significantly younger than men (μ ± sd; 36.8 ± 15.3 vs 55.9 ± 12.7, p=0.001,) whereas pre-pandemic, there was no gender differences in mean age. Non-shockable rhythm was more common (92.2%) than shockable rhythm (6.5%). Pre- and during pandemic, there were significant differences in the cause of IHCA for 4H4T (87% vs 100%) and cardiac (36% vs 9%). The proportion of hypoxic patients increased from 50% during pre-pandemic to 91% during the pandemic period, whereas hypo/hyperkalemia decreased from 53% to 34%.
Despite the limitation of a small sample size, our study has provided important information regarding the epidemiology and outcomes of IHCA pre- and during pandemic in a busy Pakistani tertiary care hospital. Our finding that gender differences exist in survival pre- and during pandemic needs to be explored further with more hospitals doing comparative studies.
确定一家三级医疗医院在疫情前及疫情期间院内心脏骤停（IHCA）的流行病学情况。
这是一项对2019年8月至2020年8月期间在卡拉奇一家三级医疗医院发生院内心脏骤停的住院患者进行的横断面研究。观察指标为自主循环恢复（ROSC）和出院存活率（StD），并对疫情前和疫情期间进行了分析比较。
在为期1年的研究期间，共有77例患者经历了至少一次IHCA事件。比较疫情前和疫情期间，女性的ROSC在疫情期间较高，尽管与男性相比无显著差异（43%对50%）（男性为54%对10%，p<0.001）。在疫情期间，发生IHCA的女性明显比男性年轻（均值±标准差；36.8±15.3对55.9±12.7，p=0.001），而在疫情前，平均年龄无性别差异。不可电击心律比可电击心律更常见（92.2%对6.5%）。在疫情前和疫情期间，IHCA的病因在4H4T方面（87%对100%）和心脏方面（36%对9%）存在显著差异。缺氧患者的比例从疫情前的50%增加到疫情期间的91%，而低钾血症/高钾血症从53%降至34%。
尽管样本量较小存在局限性，但我们的研究提供了关于一家繁忙的巴基斯坦三级医疗医院在疫情前及疫情期间IHCA的流行病学和结局的重要信息。我们发现疫情前和疫情期间在存活率方面存在性别差异，这一发现需要更多医院进行比较研究以进一步探索。
