In-hospital cardiac arrest--an Utstein style report of seven years experience from the Sahlgrenska University Hospital.
BACKGROUND
In-hospital cardiac arrest is one of the most stressful situations in modern medicine. Since 1997, there has been a uniform way of reporting - the Utstein guidelines for in-hospital cardiac arrest reporting.


METHODS
We have studied all consecutive cardiac arrest in the Sahlgrenska University Hospital (SU) between 1994 and 2001 for who the rescue team was alerted in all 833 patients. The primary endpoint for this study was survival to discharge.


RESULTS
Thirty-seven percent survived to hospital discharge. Among patients who were discharged alive, 86% were alive 1 year later. The survivors have a good cerebral outcome (94% among those who were discharged alive had cerebral performance category (CPC) score 1 or 2). The organization at SU is efficient; 80% of the cardiac arrest had CPR within 1 min. Time from cardiac arrest to first defibrillation is a median of 2 min. Almost two-thirds of the patients were admitted for cardiac related diagnoses.


CONCLUSIONS
The current study is the largest single-centre study of in hospital cardiac arrest reported according to the Utstein guidelines. We report a high survival for in-hospital cardiac arrest. We have pointed out that a functional chain of survival, short intervals before the start of CPR and defibrillation are probably contributing factors for this.
Fredriksson
Martin
M
Sahlgrenska University Hospital, Department of Cardiology, SE-413 45 Goteborg, Sweden. marty.lisa@swipnet.se
Aune
Solveig
S
Thorén
Ann-Britt
AB
Herlitz
Johan
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D003072:Cognition Disorders / Q000145:classification; D047548:Defibrillators; D004554:Electric Countershock; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology* / Q000628:therapy*; D006760:Hospitalization; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D011446:Prospective Studies; D016414:Resuscitation Orders; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors