Antecedent bradycardia and in-hospital cardiopulmonary arrest mortality in telemetry-monitored patients outside the ICU
| Autor: | Utpal Bhalala, Penny E. Rathmanner, Melody S. Kasprzak, Christopher P. Bonafide, Anita K. Witzke, Robert A. Berg, Christian M. Coletti, Marc T. Zubrow, Vinay M. Nadkarni |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Bradycardia medicine.medical_specialty Defibrillation medicine.medical_treatment Emergency Nursing law.invention Cohort Studies law Internal medicine Heart rate Prevalence medicine Humans Telemetry Hospital Mortality Survival rate Aged Retrospective Studies Aged 80 and over business.industry Retrospective cohort study Middle Aged Intensive care unit Heart Arrest Survival Rate Intensive Care Units Antecedent (behavioral psychology) Emergency Medicine Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Cohort study |
| Zdroj: | Resuscitation. 83:1106-1110 |
| ISSN: | 0300-9572 |
| DOI: | 10.1016/j.resuscitation.2012.03.026 |
| Popis: | Background Patients with in-hospital cardiopulmonary arrest (IHCA) precipitated by respiratory insufficiency often exhibit bradycardia before the arrest. We hypothesized that bradycardia frequently occurs in the 10min preceding IHCA and is associated with poor outcomes when IHCA occurs outside the intensive care unit (ICU). Objectives To determine the prevalence and association of antecedent bradycardia with outcome in adult patients with IHCA occurring outside the ICU.Methods We performed a retrospective cohort study among telemetry monitored adults with IHCA outside the ICU in a two-hospital health system between 2008 and 2010 with follow-up until their discharge or death in-hospital. We defined (1) IHCA as >1min of chest compressions or trans-thoracic defibrillation, (2) Antecedent bradycardia as at least 2min of continuous heart rate between 1 and 59 beats per minute in the 10min preceding IHCA, and (3) ventricular tachyarrhythmia arrests as presence of sustained ventricular tachyarrhythmia for >20s in the 10min preceding IHCA. Results Of 98 IHCAs, 39 (39.8%) survived to hospital discharge. Of 98 IHCAs, 53 (54.1%) had antecedent bradycardia. After adjusting for potential confounders, antecedent bradycardia was associated with death prior to hospital discharge (adjusted OR=3.80, 95%CI: 1.47–9.81, p =0.006). Among patients with ventricular tachyarrhythmia arrests, antecedent bradycardia was associated with a higher risk of death (OR=13.1, 95%CI 1.92–89.5, p =0.009). Conclusions Antecedent bradycardia occurred frequently and was associated with death prior to hospital discharge in non-ICU hospitalized adults on telemetry monitoring who developed IHCA. |
| Databáze: | OpenAIRE |
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