Outcomes of Cardiac Arrest and Resuscitation in the Emergency Department: A Retrospective Study at a Tertiary Care Center in South India.

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.