Survival from in-hospital cardiac arrest: the potential impact of infection.
OBJECTIVE
The aim of this study was to examine the relationship between outcome from cardiac arrest and infection status at the time of in-hospital cardiac arrest.


METHODS
This was a retrospective database review from a single resuscitation service supporting two major hospitals.


METHODS
Two urban University Hospitals in London.


METHODS
Data from 1436 in-patient cardiac arrest were available for analysis.


METHODS
Nil.


RESULTS
Patients were classified into infected or non-infected groups by the resuscitation audit process and the hospitals diagnostic coding unit. Survival was followed according to the in-hospital Utstein timepoints. In addition, the data were examined by presenting the cardiac rhythm. Age and length of prior hospitalisation were recorded. Infection associated diagnoses appear to be increasing in prevalence. Initial survival from cardiac arrest was not affected by infection status, but this did have a substantial impact on chance of leaving the initial hospital (odds ratio 0.52, confidence intervals 0.3-0.8), or being discharged to home (odds ratio 0.48, confidence intervals 0.4-0.8). The outcome from ventricular fibrillation/pulseless ventricular tachycardia was worse for infected patients (odds ratio for home discharge 0.37, confidence intervals 0.2-0.9), although initial survival was not significantly different.


CONCLUSIONS
Infection may be becoming an increasingly important association with cardiac arrest in the hospitalised population. Initial survival from cardiac arrest is the same as for non-infected patients, but longer term survival is much poorer. Long-term survival from ventricular fibrillation or pulseless ventricular tachycardia is relatively poor, in spite of similar initial success.
Treanor
Gilly
G
Department of Resuscitation, Hammersmith Hospital, NHS Trust, London W12 OHS, UK.
Spearpoint
Ken
K
Brett
Stephen
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D006323:Heart Arrest / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000453:epidemiology*; D007902:Length of Stay / Q000706:statistics & numerical data; D008131:London / Q000453:epidemiology; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012189:Retrospective Studies; D016019:Survival Analysis