Factors influencing the outcomes after in-hospital resuscitation in Taiwan.
BACKGROUND
The effects on prognosis of some advanced interventions established before cardiopulmonary resuscitation are not clear. The outcomes and patterns of various factors of in-hospital resuscitation are also influenced by different disease patterns in different areas. We studied the factors related to outcomes in an oriental country.


METHODS
We studied the in-hospital resuscitation events in a tertiary medical center in Taipei city, Taiwan. All events and variables were recorded using the Utstein style for in-hospital resuscitation. We measured the influence of patients and event variables on the outcomes of return of spontaneous circulation (ROSC) and survival to discharge.


RESULTS
The rate of establishing a ROSC was 67% and the rate of survival to discharge was 17% in the studied population. The 1-year survival rate was 3.9%. Only 17% of the patients resuscitated had coronary artery disease. VT/VF was the initial rhythm in only 13.6% patients. Nearly half (49%) of the resuscitation attempts took place in emergency department (ED). Patients who were already intubated or had received mechanical ventilation before resuscitation had reduced chances of achieving ROSC. (P<0.05). Favorable prognostic factors of survival to discharge were shorter time intervals from patient collapse to arrival of the resuscitation team (69 vs. 154 s, P<0.05) and to confirmation of arrest (93 vs. 217 s, P<0.05).


CONCLUSIONS
Intubation and mechanical ventilation already established before arrest implies an underlying critical illness and reduce the chances of ROSC. Shorter intervals from collapse to resuscitation improve the chance of survival to discharge. The high proportion of resuscitation events occurring in the ED, reflecting ED overcrowding, and low frequency of pre-existing coronary artery disease are unique to our country.
Huang
Chien-Hua
CH
Department of Emergency Medicine, National Taiwan University Hospital, No. 7 Chung-Shan S. Road, Taipei, Taiwan.
Chen
Wen-Jone
WJ
Ma
Matthew Hei-Ming
MH
Chang
Wei-Tien
WT
Lai
Chao-Lun
CL
Lee
Yuan-Teh
YT
D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000401:mortality*; D003327:Coronary Disease / Q000150:complications; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology