Incidence and outcome of in-hospital cardiac arrest in Italy: a multicentre observational study in the Piedmont Region

Autor: Paola Berchialla, Agostino Roasio, Roberto Penso, Felice Urso, Ugo Zummo, Andrea Fassiola, Giacomo Berta, Giuseppe Ristagno, Giulio Radeschi, Andrea Mina, Claudio Sandroni
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Resuscitation
Epidemiology
medicine.medical_treatment
Cardiopulmonary resuscitation
In-hospital cardiac arrest
Outcome
Emergency Medicine
Emergency Nursing
Cardiology and Cardiovascular Medicine
Comorbidity
030204 cardiovascular system & hematology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Interquartile range
Settore MED/41 - ANESTESIOLOGIA
Outcome Assessment
Health Care
medicine
Humans
Survival rate
Aged
Proportional Hazards Models
Aged
80 and over
Inpatients
business.industry
Incidence
Incidence (epidemiology)
030208 emergency & critical care medicine
Middle Aged
medicine.disease
Survival Analysis
Cardiopulmonary Resuscitation
Heart Arrest
Surgery
Hospitalization
Italy
Ventricular fibrillation
Emergency medicine
Female
business
Cohort study
Zdroj: Resuscitation. 119:48-55
ISSN: 0300-9572
DOI: 10.1016/j.resuscitation.2017.06.020
Popis: Aims to report the incidence, characteristics, and outcome of in-hospital cardiac arrest (IHCA) in a large Italian region. Setting all hospitals participating in the IHCA Registry Initiative of Piedmont. Methods observational cohort study in adult (>18 year old) inpatients resuscitated from IHCA during three consecutive years (2012–2014). The main outcome measures were IHCA incidence and survival to hospital discharge. Results A total of1539 arrests in adult inpatients were recorded in the study period, yielding an overall incidence of 1.51 arrests/1000 admissions. The incidence was highest at day 1 after hospital admission and in the morning hours, with a peak at 9.00 a.m. Median age was 77 (interquartile range 68–83) years. The presenting rhythm was ventricular fibrillation/pulseless ventricular tachycardia in 291/1539 (18.9%) cases. A total of 549/1539 (35.7%) patients achieved recovery of spontaneous circulation (ROSC) and 228/1539(14.8%) survived hospital discharge, with 207 (90.8%) of the latter having good neurological outcome (Cerebral Performance Categories [CPC] 1 or 2).After adjustment for major confounders, a pre-arrest CPC = 1, a cardiac cause of arrest, a shockable presenting rhythm, and a shorter duration of resuscitation were independently associated with a higher likelihood of survival to discharge. Conclusions in this Italian registry the incidence of IHCA and its circadian distribution were comparable to those in the NCAA registry in the UK. Patients were older and had a lower ROSC rate than these observed in other large IHCA registries, but post-ROSC survival rate and factors affecting survival to discharge were similar.
Databáze: OpenAIRE
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