Krishnan Rajarajeswaran, Prasad Hari, Cm Dhileeban, Raaj Deebak, K Prahadheeshwar, Bhandari Ashni
Emergency Medicine, SRM Medical College Hospital and Research Centre, Chennai, IND.
Biostatistics and Epidemiology, Sree Balaji Medical College & Hospital, Chennai, IND.
Cureus. 2025 Jul 24;17(7):e88646. doi: 10.7759/cureus.88646. eCollection 2025 Jul.
Cardiac arrest is a critical medical emergency associated with high mortality and variable neurological outcomes. Despite advancements in resuscitation practices, survival following cardiac arrest remains suboptimal in many healthcare settings. This study aimed to evaluate the clinical and neurological outcomes of patients who experienced cardiac arrest in the emergency department of a tertiary care center and to identify key factors influencing survival.
This retrospective observational study was conducted at SRM Medical College Hospital and Research Centre, Kattankulathur, between August 2024 and May 2025. A total of 240 patients with documented cardiac arrest that occurred in the emergency department were included. Of these, some were later transferred to the intensive care unit (ICU) for continued management. Data on demographics, arrest characteristics, initial rhythm, time to cardiopulmonary resuscitation (CPR), return of spontaneous circulation (ROSC), survival beyond 48 hours, neurological outcomes, and need for ventilatory support were collected and analyzed.
Among the 240 patients included, 160 (66.6%) were male. Most cardiac arrests were witnessed events (n = 225, 93.8%), and all occurred in the emergency department (n = 240, 100%). A total of 107 patients (44.6%) were subsequently transferred to the ICU for ongoing care following initial resuscitation. The initial cardiac rhythm was non-shockable in 200 patients (83.3%) and shockable in 40 patients (16.7%). CPR was initiated within one minute in 156 patients (65.0%) and within two to three minutes in 84 patients (35.0%). ROSC was achieved in 154 patients (64.1%), and survival beyond 48 hours was observed in 154 patients (64.1%). Among the survivors, 111 (72.1%) had a Glasgow Coma Scale (GCS) score of 15/15 at discharge, while 17 (10.8%) required mechanical ventilation at the time of discharge.
In this cohort, the ROSC and early survival rates were relatively high, likely due to the large proportion of witnessed and in-hospital cardiac arrests, as well as rapid CPR initiation. A majority of survivors had favorable neurological outcomes, emphasizing the importance of prompt and effective resuscitation practices in improving survival and neurological recovery.
心脏骤停是一种严重的医疗紧急情况，死亡率高且神经学预后各异。尽管复苏实践有所进步，但在许多医疗环境中，心脏骤停后的生存率仍不理想。本研究旨在评估在一家三级医疗中心急诊科发生心脏骤停的患者的临床和神经学预后，并确定影响生存的关键因素。
这项回顾性观察研究于2024年8月至2025年5月在卡特坦库拉特的SRM医学院医院及研究中心进行。共纳入240例在急诊科有记录的心脏骤停患者。其中，一些患者后来被转至重症监护病房（ICU）进行持续治疗。收集并分析了有关人口统计学、骤停特征、初始心律、心肺复苏（CPR）时间、自主循环恢复（ROSC）、48小时后生存率、神经学预后以及通气支持需求的数据。
在纳入的240例患者中，160例（66.6%）为男性。大多数心脏骤停为目击事件（n = 225，93.8%），且均发生在急诊科（n = 240，100%）。共有107例患者（44.6%）在初始复苏后被转至ICU进行后续治疗。200例患者（83.3%）的初始心律不可电击，40例患者（16.7%）的初始心律可电击。156例患者（65.0%）在1分钟内开始进行CPR，84例患者（35.0%）在2至3分钟内开始进行CPR。154例患者（64.1%）实现了ROSC，154例患者（64.1%）观察到48小时后存活。在幸存者中，111例（72.1%）出院时格拉斯哥昏迷量表（GCS）评分为15/15，而17例（10.8%）出院时需要机械通气。
在该队列中，ROSC和早期生存率相对较高，可能是由于目击和院内心脏骤停的比例较大，以及CPR启动迅速。大多数幸存者有良好的神经学预后，强调了及时有效的复苏实践对提高生存率和神经学恢复的重要性。
