Khan Muhammad Faisal, Shafiq Omer, Hirani Sana, Sabeen Amber, Akhtar Sheikh Sijal, Abbas Qalab, Munir Tahir, Atiq Huba, Hashwani Yasmin, Latif Asad
Department of Anesthesiology, Aga Khan University, Karachi, Pakistan.
Department of Nursing Services and Department of Medicine.
Resusc Plus. 2024 Sep 13;20:100775. doi: 10.1016/j.resplu.2024.100775. eCollection 2024 Dec.
In hospital cardiac arrest is associated with poor survival despite basic and advanced life support measures. This study aimed to identify the clinical characteristics and outcomes of cardiac arrests occurring during in-hospital admission to the tertiary care center in Pakistan.
A retrospective, cross-sectional study at Aga Khan University Hospital from 2021 to 2023 analyzed 230 cardiac arrest cases. Data included demographics, arrest type, timing, initial rhythm, resuscitation duration, and arrest location. American Heart Association guidelines were adhered to for life support. The main outcomes focused on the return of spontaneous circulation survival to hospital discharge.
During the study, 230 cardiac arrests were observed: 152 in adults (mean age 57.8, 142 shockable cases, ROSC 52.6 %, alive at discharge 28.3 %) and 78 in pediatric patients (mean age 4.99, non-shockable rhythm 85.9 %, ROSC 51.3 %, alive at discharge 17.9 %). Adult Charles comorbidity index: 2.88 (SD±2.08), pediatric index: 0.610 (SD±0.88). Survival rates were lower with a high comorbidity index and code duration > 20 min.
The study provides valuable observational data that challenges global survival rates for in-hospital cardiac arrest. It highlights how factors like being in monitored units and the presence of rapid response teams can lead to higher survival rates. The research underscores the influence of comorbidities, initial rhythms, and the duration of resuscitation efforts on patient outcomes, emphasizing the need for more research, especially in settings with limited resources.
尽管采取了基本和高级生命支持措施，但医院内心脏骤停的生存率仍较低。本研究旨在确定巴基斯坦三级医疗中心住院期间发生的心脏骤停的临床特征和结局。
对阿迦汗大学医院2021年至2023年的230例心脏骤停病例进行回顾性横断面研究。数据包括人口统计学、骤停类型、时间、初始心律、复苏持续时间和骤停地点。遵循美国心脏协会指南进行生命支持。主要结局集中在自主循环恢复至出院存活情况。
研究期间观察到230例心脏骤停：成人152例（平均年龄57.8岁，142例可电击心律病例，自主循环恢复率52.6%，出院存活28.3%），儿科患者78例（平均年龄4.99岁，不可电击心律85.9%，自主循环恢复率51.3%，出院存活17.9%）。成人查尔森合并症指数：2.88（标准差±2.08），儿科指数：0.610（标准差±0.88）。合并症指数高和心肺复苏持续时间>20分钟时生存率较低。
本研究提供了有价值的观察数据，对全球医院内心脏骤停的生存率提出了挑战。它强调了诸如在监护病房以及快速反应团队的存在等因素如何能够导致更高的生存率。该研究强调了合并症、初始心律和复苏努力持续时间对患者结局的影响，强调需要进行更多研究，尤其是在资源有限的环境中。
