Alao David O, Mohammed Nada A, Hukan Yaman O, Al Neyadi Maitha, Jummani Zia, Dababneh Emad H, Cevik Arif A
Department of Emergency Medicine Al Ain Hospital, Al Ain, United Arab Emirates.
Department of Internal Medicine, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
Resusc Plus. 2022 Mar 19;10:100220. doi: 10.1016/j.resplu.2022.100220. eCollection 2022 Jun.
In-Hospital Cardiac Arrest (IHCA) is a significant burden on healthcare worldwide. Outcomes of IHCA are worse in developing countries compared with developed ones. We aimed to study the epidemiology and factors determining outcomes in adult IHCA in a high income developing country.
We abstracted prospectively collected data of adult patients admitted to our institution over a three-year period who suffered a cardiac arrest. We analysed patient demographics, arrest characteristics, including response time, initial rhythm and code duration. Pre-arrest vital signs, primary diagnoses, discharge and functional status, were obtained from the patients' electronic medical records.
A total of 447 patients were studied. The IHCA rate was 8.6/1000 hospital admissions. Forty percent (40%) achieved ROSC with an overall survival to discharge rate of 10.8%, of which 59% had a good functional outcome, with a cerebral performance category score of 1 or 2. Fifty-four percent (54%) of patients had IHCA attributed to causes other than cardiac or respiratory. Admission Glasgow Coma Scale (GCS), shockable rhythm and short code duration were significantly associated with survival (p < 0.001).
A combination of patient and system-related factors, such as the underlying cause of cardiac arrest and a lack of DNAR policy, may explain the reduced survival rate in our setting compared with developed countries.
院内心脏骤停（IHCA）给全球医疗保健带来了沉重负担。与发达国家相比，发展中国家的院内心脏骤停结局更差。我们旨在研究一个高收入发展中国家成年院内心脏骤停的流行病学及决定结局的因素。
我们提取了前瞻性收集的在三年期间入住我院且发生心脏骤停的成年患者的数据。我们分析了患者的人口统计学特征、骤停特征，包括反应时间、初始心律和心肺复苏持续时间。心脏骤停前的生命体征、主要诊断、出院情况及功能状态，均从患者的电子病历中获取。
共研究了447例患者。院内心脏骤停发生率为8.6/1000次住院。40%的患者实现了自主循环恢复（ROSC），总体出院生存率为10.8%，其中59%的患者功能结局良好，脑功能分类评分为1或2。54%的患者院内心脏骤停的病因并非心脏或呼吸相关。入院时格拉斯哥昏迷量表（GCS）评分、可电击心律和较短的心肺复苏持续时间与生存显著相关（p < 0.001）。
患者和系统相关因素的综合作用，如心脏骤停的潜在病因及缺乏不进行心肺复苏（DNAR）政策，可能解释了与发达国家相比我们研究环境中生存率较低的原因。
